XVS-12473-95019
3 vaccinations
4 coded responses
24 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 622 / IL
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
-
2021-01-18
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Lymphadenopathy — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Lymph node swelling- painful on injection sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-19
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: Axilla Lymph node swelling and painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-02-01
- 2021-02-08
- 2021-02-15
-
2021-02-19
Dose 2 — Moderna
- 2021-02-22
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-05-10
- 2021-05-21
- 2021-08-20
-
2022-01-10
Dose 3 — Moderna
- 2022-02-19
-
2022-07-13
Survey response — 6 months, dose 3MedDRA: COVID-19, Headache, Hydrocephalus, Migraine — 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 professional · Outpatient clinic or urgent care clinic visitFree text: Covid 19 last month. Diagnosed with excess CSF on my brain causing headaches/migrainesMedDRA releases: 2024-11 · check-in free text available
-
2022-07-13
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-14
- 2022-07-14
-
2023-01-10
Survey response — 12 months, dose 3MedDRA: Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-10
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-11
- 2023-01-11
- 2023-01-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2022-01-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-19 | Unsuccessful | |
| 2022-07-13 | Unsuccessful | |
| 2023-01-10 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Lymph node swelling- painful on injection side
Systemic reaction (other): Axilla Lymph node swelling and pain
Release 12 — 6 months, dose 3
Symptoms: Covid 19 last month. Diagnosed with excess CSF on my brain causing headaches/migraines
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 | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hydrocephalus | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release