XW5-11797-63385
3 vaccinations
7 coded responses
27 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 921 / CA
- Registered
- 2021-03-30
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-07
Dose 1 — Moderna
-
2021-03-30
Registered in v-safe
- 2021-03-30
-
2021-04-04
Dose 2 — Moderna
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Feeling of body temperature change — Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Hot flush — Feeling: Good · Site: Pain, Itching · HeadacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Hot flush — Feeling: Good · Site: Pain, ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-11
- 2021-04-19
- 2021-04-26
- 2021-05-02
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2021-05-09
Survey response — 35 day, dose 2MedDRA: Unevaluable event — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-16
- 2021-07-04
- 2021-10-03
-
2021-12-10
Dose 3 — Moderna
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
- 2021-12-17
- 2021-12-24
- 2022-01-01
- 2022-01-07
- 2022-01-14
- 2022-01-21
- 2022-03-11
- 2022-06-15
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2022-12-11
Survey response — 12 month, dose 3MedDRA: Productive cough, Respiratory disorder, Secretion discharge, Sinus congestion — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-07 | Moderna | |
| 2 | 2021-04-04 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
Free text
Release 6
Systemic reaction (other): Injection site pain was worse (moderate) between midnight and 8:00 am. Mild pain now.
Release 7
Systemic reaction (other): I think I had a very mild fever due to short mild hot/cold spells
Systemic reaction (other): Hot flashes
Systemic reaction (other): Hot flashes
Systemic reaction (other): The pain and itching at the injection site are VERY mild.
Release 8
Symptoms: Severe headache but I don't think it was COVID related. I occasionally have severe sinus headaches and I think it was one of those.
Release 12
Symptoms: Respiratory issues ... e.g., mucous coughed up, sinus blocked. But I think this is due to allergies flaring up recently.
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 | Productive cough | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Feeling of body temperature change | ✓ | ✓ | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release