XVA-13270-69795
4 vaccinations
5 coded responses
30 check-ins
4 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 66+
- ZIP prefix
- 374 / TN
- 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
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: Good · Site: Redness, Swelling · FeverMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-11
- 2021-01-14
- 2021-01-20
- 2021-01-26
- 2021-02-02
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Joint painsAdult check-in
- 2021-02-06
-
2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
-
2021-05-06
Survey response — 3 month, dose 2MedDRA: Body temperature increased — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-08-05
Survey response — 6 month, dose 2MedDRA: Arthritis — Feeling: Good · 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: 2021-09,2024-11 · check-in answers available
-
2021-08-05
Report sent to call center — 6 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-20
Dose 3 — Moderna
- 2021-11-19
- 2021-11-21
-
2022-02-11
Dose 4 — Pfizer-BioNTech
- 2022-02-20
-
2022-05-13
Survey response — 3 month, dose 4MedDRA: Abdominal pain upper, Adverse reaction, Diarrhoea, Medical counselling, Self-medication — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-05-13
Report sent to call center — 3 month, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-05-17
- 2022-05-17
- 2022-08-12
-
2023-02-11
Survey response — 12 month, dose 4MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-08-20 | Moderna | No |
| 4 | 2022-02-11 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-05 | Unsuccessful | |
| 2022-05-13 | Unsuccessful |
Free text
Release 1
Systemic reaction (other): Dry coughing non-productive
Release 8
Symptoms: One and one half weeks with slight elevation of temp. Extreme moisture pouring from pours in upper body. Dr. said if it continues with a higher elevation to get back in touch. This was my regular appointment. So, Ill click no on next question.
Release 9
Symptoms: Arthritis of spine given a steroid injection.
Release 11
Symptoms: About 10 days of loose stools. 3 days with and several days without over a period of about a month. Called the Dr. who wanted a sample and I was unable to give him one. Lots of stomach pain. Took OTC meds. Do not believe it was COVID related.
Healthcare visit (other): Called and described symptons and went by the office to pick up sample kit.
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 | Adverse reaction | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Arthritis | ✓ | · | ✓ |
| SD | Body temperature increased | ✓ | ✓ | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release