XVM-80857-29462
4 vaccinations
3 coded responses
16 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 992 / WA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness, NauseaAdult check-in
- 2021-04-06
- 2021-07-01
- 2021-09-30
-
2021-11-04
Dose 3 — Moderna
- 2022-04-01
-
2022-04-05
Dose 4 — Moderna
-
2022-04-26
Survey response — 21 day, dose 4MedDRA: COVID-19, Dyspnoea, Pre-existing disease, Self-medication — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2022-05-03
- 2022-05-10
- 2022-05-17
-
2022-07-05
Survey response — 3 month, dose 4MedDRA: Asthma, C-reactive protein increased, COVID-19, Dyspnoea, Hypertension, Pre-existing disease — Feeling: Fair · 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
-
2022-07-05
Report sent to call center — 3 month, dose 4Be 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)
- 2022-07-06
-
2023-04-05
Survey response — 12 month, dose 4MedDRA: Respiratory tract infection viral — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-04-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-05 | Unsuccessful |
Free text
Release 11
Symptoms: I am having more trouble breathing due to allergy season and getting covid in January. I am getting my allergy shots every three weeks and taking Benadryl once a day plus my normal anti-histamine.
Release 12
Symptoms: My breathing continues to be difficult since spring. I have increased my bp meds due to sustained high bp, 2 puffs 2x a day advair for asthma. My asthma has advanced. Also have high CPR inflammation confirmed by blood test. Due to covid + Jan 2022 cut off by CDC
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 |
|---|---|---|---|---|
| SD | Asthma | · | · | ✓ |
| SD | C-reactive protein increased | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release