XV5-69470-19764
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 454 / OH
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-05
- 2021-01-06
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-19
-
2021-01-26
Survey response — 21 day, dose 1MedDRA: Ear pain, Headache, SARS-CoV-2 test negative — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-02
-
2021-02-11
Survey response — 35 day, dose 1MedDRA: Blood pressure increased — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-16
Dose 2 — Moderna
-
2021-02-16
Health check-in — 0 day, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body achesAdult check-in
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-21
- 2021-02-23
- 2021-03-03
- 2021-03-09
- 2021-03-17
- 2021-03-23
- 2021-04-01
- 2021-05-18
-
2021-08-17
Survey response — 6 month, dose 2MedDRA: Emergency care, Mammogram abnormal, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-08-17
Report sent to call center — 6 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-24
- 2022-02-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-16 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-17 | Unsuccessful |
Free text
Release 2
Symptoms: Left ear pain, so HA; I had a covid test yesterday and it was negative
Release 4
Symptoms: Yes... wasPrescribed an anti hypertensive and diuretic for elevated blood pressure... I had never had HTN before
Release 9
Symptoms: I had a mammogram in June that needed a follow up diagnostic mammogram of my right breast and axillary area. June 17 I had a ER axillary biopsy and right breast biopsy. Biopsies were negative. This was approx 4 months after my 2nd covid vaccinatio cut off by CDC
Healthcare visit (other): Radiology for breast and axillary biopsy
Free-text releases are not linked to a specific survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | · | ✓ |
| SD | Blood pressure increased | ✓ | ✓ | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Mammogram abnormal | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release