XW6-11502-90209
3 vaccinations
5 coded responses
27 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 977 / OR
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- Other
- Ethnicity
- N/A
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Moderna
- 2021-03-31
-
2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
-
2021-05-05
Dose 2 — Moderna
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-05-07
- 2021-05-08
-
2021-05-09
Survey response — days 1–6 daily, dose 2MedDRA: Contusion — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-10
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-11
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
-
2021-06-16
Survey response — 42 day, dose 2MedDRA: Peripheral swelling, Rash, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-06-16
Report sent to call center — 42 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-24
-
2021-08-04
Survey response — 3 month, dose 2MedDRA: Rash — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-11-03
Survey response — 6 month, dose 2MedDRA: Chills, Exposure to SARS-CoV-2, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2021-12-06
Dose 3 — Moderna
- 2022-06-06
- 2022-12-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-05-05 | Moderna | |
| 3 | 2021-12-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-16 | Unsuccessful |
Free text
Release 8
Systemic reaction (other): Just very bruised
Systemic reaction (other): No just the rash
Release 9
Symptoms: I broke out with a rash as I mentioned before and my forearms got swollen. I did make an appointment to see a doctor and I guess he chose not to see me on 6/3/21 .
Healthcare visit (other): Never got seen
Symptoms: I broke down with a rash. I went to dr but never got seen. CDC called but hung up after second ring . Im doing much better since the rash attacked just bout my entire body. Im doing ok ty.
Release 10
Symptoms: A cold like chest congestion feverish sore throat, chills. Unfortunately I came in contact with someone who had COVID. I went to get the test came negative but I don't think I did it right .
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release