XVV-13057-59482
4 vaccinations
9 coded responses
40 check-ins
9 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 344 / FL
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-10
Dose 1 — Moderna
-
2021-02-07
Dose 2 — Moderna
-
2021-02-09
Registered in v-safe
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-21
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-03-21
-
2021-05-09
Survey response — 3 month, dose 2MedDRA: Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-09
Report sent to call center — 3 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-08
Survey response — 6 month, dose 2MedDRA: Lymph node pain, Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-08-08
Report sent to call center — 6 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-14
-
2021-10-27
Dose 3 — Moderna
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy, Office visit, Vaccine positive rechallenge — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2021-10-30
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain — Feeling: Good · Muscle or body achesMedDRA releases: 2024-11 · check-in answers available
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
-
2021-11-03
Survey response — 7 day, dose 3MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-11-03
- 2021-11-12
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
-
2022-04-20
Dose 4 — Moderna
-
2022-04-20
Survey response — 0 day, dose 4MedDRA: Injection site pain — Feeling: Good · Site: PainMedDRA releases: 2024-11 · check-in answers available
-
2022-04-21
Health check-in — days 1–6 daily, dose 4Feeling: Good · Headache, Muscle or body achesAdult check-in
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-05-04
-
2022-05-11
Survey response — 21 day, dose 4MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
- 2022-05-18
- 2022-05-26
- 2022-06-01
- 2022-07-20
- 2022-10-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-10 | Moderna | |
| 2 | 2021-02-07 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-09 | Unsuccessful | |
| 2021-08-08 | Unsuccessful | |
| 2021-10-30 | Unsuccessful |
Free text
Release 8
Symptoms: Swollen lymph node(s) in left armpit. ( Had COVID shot in left arm.) Painful at times, mainly discomfort.
Healthcare visit (other): Office visit, ultrasound of area, scheduled for biopsy.
Release 9
Symptoms: Swollen lymph node in left armpit. Sore to touch. Being watched for any change in size.
Healthcare visit (other): Doctor appointment and ultra sound of left armpit. Being watch for any change.
Release 10
Systemic reaction (other): Swollen nodes in left armpit - - got vaccine in upper left arm. Same reaction as original Co-vid vaccine shots.
Healthcare visit (other): Had wellness check and told doctor about swollen nodes again with the booster shot.
Systemic reaction (other): Tender left armpit lymph nodes.
Systemic reaction (other): Sore left armpit area.
Systemic reaction (other): Sore left armpit - - getting better
Systemic reaction (other): Left armpit
Release 11
Systemic reaction (other): Slight ache at injection sight.
Symptoms: Back to knee pain. Doctor thinks it's arthritis in my right hip.
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 | Lymphadenopathy | · | · | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Vaccine positive rechallenge | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Lymph node pain | ✓ | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release