XVC-32203-70912
3 vaccinations
5 coded responses
40 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 691 / NE
- 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
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
-
2021-01-20
Survey response — 14 day, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site warmth, Self-medication — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-26
-
2021-02-02
Dose 2 — Moderna
- 2021-02-02
- 2021-02-03
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Itching · NoneAdult check-in
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
-
2021-03-09
Survey response — 35 day, dose 2MedDRA: Arthralgia, Pain in extremity, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2021-10-25
Dose 3 — Moderna
- 2021-10-25
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body achesAdult check-in
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Itching · NoneAdult check-in
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · Muscle or body achesAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
-
2021-11-23
Survey response — 28 day, dose 3MedDRA: Erythema, Pruritus — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
- 2021-11-29
-
2021-12-06
Survey response — 42 day, dose 3MedDRA: Erythema, Office visit, Pruritus, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2021-12-06
Report sent to call center — 42 day, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-07
-
2021-12-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-25
-
2022-10-25
Survey response — 12 month, dose 3MedDRA: COVID-19 — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-06 | Successful 2021-12-08 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2
Symptoms: The evening of January 12th my injection site began to itch. By the next morning the site was red and felt warm to the touch. The itching was worse. I used Benadryl for several days. My arm feels fine now.
Release 5
Symptoms: Pain in left heel. Last three or four mornings I have been awakened with extreme pain in my left hip. This pain has worsened each morning.
Release 10
Symptoms: Redness on neck with itching. Worse today than yesterday.
Symptoms: Redness on my lower neck with itching. Allergy meds do not seem to help.
Healthcare visit (other): Family doctor
Release 12
Symptoms: Positive for Covid July 11th.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Sleep disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release