XVW-15987-53136
5 vaccinations
17 coded responses
42 check-ins
16 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 933 / CA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-09
Dose 1 — Moderna
-
2021-02-11
Registered in v-safe
- 2021-02-11
- 2021-02-12
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2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Fair · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-17
Survey response — 7 day, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-23
- 2021-03-02
-
2021-03-09
Dose 2 — Moderna
- 2021-03-09
-
2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain, Pre-existing disease — Feeling: Good · Site: Pain · Abdominal painMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Muscle or body aches, Abdominal painMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-12
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2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Myalgia — Feeling: Good · Muscle or body aches · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Good · Muscle or body aches · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-16
Survey response — 7 day, dose 2MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-23
-
2021-03-30
Survey response — 21 day, dose 2MedDRA: Cough, Productive cough — Feeling: Good · Be unable to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-04-06
Survey response — 28 day, dose 2MedDRA: Asthma, Gastrooesophageal reflux disease, Productive cough, Upper-airway cough syndrome — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-13
- 2021-04-20
- 2021-06-08
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2021-09-07
Survey response — 6 month, dose 2MedDRA: Gastrooesophageal reflux disease, Muscle spasms — 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 · check-in answers available
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2021-09-07
Report sent to call center — 6 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-14
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2021-09-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2021-10-18
Dose 3 — Moderna
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2022-03-09
Survey response — 12 month, dose 2MedDRA: Myalgia — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
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2022-04-26
Dose 4 — Moderna
- 2022-05-19
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2022-05-24
Survey response — 28 day, dose 4MedDRA: Body temperature increased, Chills, Cough, Headache, Increased bronchial secretion, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
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2022-05-24
Report sent to call center — 28 day, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-25
- 2022-05-31
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2022-06-08
Survey response — 42 day, dose 4MedDRA: Abdominal pain, Back pain, Dysuria, Pollakiuria, Urinary tract infection — 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
-
2022-06-08
Report sent to call center — 42 day, 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)
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2022-07-26
Survey response — 3 month, dose 4MedDRA: Asthma, COVID-19 — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2022-07-26
Report sent to call center — 3 month, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-28
- 2022-07-28
- 2022-07-28
- 2022-07-28
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2022-08-04
Call successfulCompleted over the phone
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2022-08-04
Call successfulCompleted over the phone
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2022-08-04
Call successfulCompleted over the phone
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2022-09-13
Dose 5 — ModernaCo-administered: Flu
- 2022-09-13
-
2022-09-14
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-27
- 2022-10-04
- 2022-10-13
- 2022-10-18
- 2022-10-27
- 2022-12-15
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2023-03-14
Survey response — 6 month, dose 5MedDRA: Body temperature increased, COVID-19, Cough, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2023-03-14
Report sent to call center — 6 month, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2023-03-15
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-09 | Moderna | |
| 3 | 2021-10-18 | Moderna | No |
| 4 | 2022-04-26 | Moderna | No |
| 5 | 2022-09-13 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-07 | Successful 2021-09-14 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-24 | Successful 2022-08-04 |
Completed over the phone |
| 2022-06-08 | Successful 2022-08-04 |
Completed over the phone |
| 2022-07-26 | Successful 2022-08-04 |
Completed over the phone |
| 2023-03-14 | Successful 2023-03-15 |
Completed over the phone |
Free text
Release 4
Systemic reaction (other): I often have these symptos periodic lt. They dont feel flu like or generalized.
Systemic reaction (other): From chronic condition..
Systemic reaction (other): Condition above stil related to previous conditions.
Systemic reaction (other): But the pain is related to Im going health issues.
Release 5
Systemic reaction (other): Pretty sure the abdominal pain was from ongoing acid reflux & chronic constipation I. Had already.
Systemic reaction (other): Both symptoms were related to ongoing health problems.
Systemic reaction (other): Muscle aches part of ongoing health conditions.
Systemic reaction (other): Above symptoms related to on going conditions.
Systemic reaction (other): Above relates to ongoing conditions
Release 6
Symptoms: Asthmatic cough & excessive Glen production.
Release 7
Symptoms: Increasing cough and phlegm production from postnasal drip, acid reflux, and asthma.
Release 9
Symptoms: GERDNECK & back spasms
Release 11
Symptoms: Achey muscjes
Symptoms: Headache, increased temperature, chills, cough, bronchial mucus production, runny nose, sore throat
Symptoms: UTI-Abdominal pain, back pain, and burning and frequency on urination
Release 12
Symptoms: I developed Covid 6 wks after my 2nd booster. Asthmatic Bronchitis requiring more frequent use of Albuterol inhaler than ever developed after Covid. Doctor has ordered a new pulmonary function test to see what has changed & or progressed.
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 | Abdominal pain | · | · | ✓ |
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dysuria | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Increased bronchial secretion | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pollakiuria | · | · | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release