XV9-65725-09538
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 799 / TX
- Registered
- 2021-04-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-09
Registered in v-safe
-
2021-04-09
Dose 1 — Moderna
- 2021-04-09
-
2021-04-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-16
- 2021-04-23
-
2021-04-30
Survey response — 21 day, dose 1MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-05
Dose 2 — Moderna
-
2021-05-06
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state, Dizziness, Syncope — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-05-10
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Pain — Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-11
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Sleep disorder — Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-12
Health check-in — 7 day, dose 2Feeling: Fair · Site: Swelling, Itching · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-16
- 2021-08-04
- 2021-11-03
-
2022-05-05
Survey response — 12 month, dose 2MedDRA: Gastrointestinal disorder, Irritable bowel syndrome, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2022-05-05
Report sent to call center — 12 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-06
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Moderna | |
| 2 | 2021-05-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-05 | Successful 2022-05-06 |
Not applicable - Accidental Reporting |
Free text
Release 8
Symptoms: Achey, fatigued
Systemic reaction (other): 5/5/2021 approx 4pm Fainted; Dizzy and confused
Systemic reaction (other): Im dragging around like im 90. Feel so tired and slept after an appointment. Had to cancel landscaper today. I was tired yesterday, but today I feel like i got hit by a truck.
Systemic reaction (other): Very fatigued. Been sleeping on and off for days.
Release 11
Symptoms: IBS and gastric issues for the past month. Saw physician and GI specialist for Abdominal/pelvic CT. All clear.
Healthcare visit (other): GI specialist
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 | Office visit | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Irritable bowel syndrome | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release