XW5-22701-53070
2 vaccinations
12 coded responses
23 check-ins
12 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 925 / CA
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
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2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-18
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-19
- 2021-01-21
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2021-01-23
Survey response — 7 day, dose 1MedDRA: Heart rate increased — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-30
- 2021-02-06
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2021-02-13
Dose 2 — Moderna
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2021-02-13
Health check-in — 0 day, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Tachycardia — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Nausea · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Good · Site: Pain, Itching · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Good · Site: ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Good · Site: ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-21
Survey response — 7 day, dose 2MedDRA: Heart rate increased — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-28
Survey response — 14 day, dose 2MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
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2021-05-15
Survey response — 3 month, dose 2MedDRA: Back pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-08-14
Survey response — 6 month, dose 2MedDRA: Back pain, Loss of personal independence in daily activities, Pain — Feeling: GoodMedDRA releases: 2021-09,2024-11 · check-in answers available
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2022-02-13
Survey response — 12 month, dose 2MedDRA: Fatigue — 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 · 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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2022-02-13
Report sent to call center — 12 month, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-17 | priority 2/3 | |
| 2021-01-18 | priority 2/3 | |
| 2022-02-13 | Unsuccessful |
Free text
Release 2
Systemic reaction (other): Noticed my average heart rate has been trending higher than normal (fitbit)
Release 4
Systemic reaction (other): Fast pulse
Systemic reaction (other): Fast pulse
Systemic reaction (other): Fast pulse
Systemic reaction (other): Fast pulse
Systemic reaction (other): Fast pulse
Systemic reaction (other): Fast pulse, improving
Systemic reaction (other): Fast pulse
Symptoms: Weird thing happening with a toe. Not sure what it is, or it is vaccine related.
Release 8
Symptoms: It occurred to me that my sudden burning back pains started around the time of the 2nd shot. They take my breath away, but only last about 5 minutes per incident. They have decreased in frequency, this month.
Release 9
Symptoms: Still getting random burning pain in regions of back. Becoming less frequent. Lasts about 3 minutes, when it happens, can't function until it passes.
Release 11
Symptoms: 6 weeks of extreme fatigue mid August until end of September.
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release