XVC-16907-97326
4 vaccinations
2 coded responses
42 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 803 / CO
- Registered
- 2021-04-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Dose 1 — Moderna
-
2021-04-09
Registered in v-safe
-
2021-04-09
Health check-in — day 7, dose 1Feeling: Fair · Site: Redness · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-04-15
- 2021-04-22
-
2021-04-29
Dose 2 — Moderna
- 2021-04-29
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-07-29
-
2021-10-28
Survey response — 6 months, dose 2MedDRA: Alopecia, Cough, Headache, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Cough, runny nose, headache, hair lossMedDRA releases: 2024-11 · check-in free text available
-
2021-11-11
Dose 3 — Moderna
- 2021-11-17
- 2021-11-19
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2022-02-10
- 2022-05-14
-
2022-09-20
Dose 4 — Moderna
- 2022-09-20
-
2022-09-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-10-04
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-11-01
- 2022-12-20
-
2023-03-21
Survey response — 6 months, dose 4MedDRA: COVID-19, Fatigue, Headache, Nasopharyngitis, Paranasal sinus hypersecretion, Sinus disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-03-21
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-03-22
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-09-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-21 | Successful 2023-03-22 |
Completed over the phone |
Free text
Release 10 — 6 months, dose 2
Symptoms: Cough, runny nose, headache, hair loss
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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 |
|---|---|---|---|---|
| SD | Alopecia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinus disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release