XW8-26179-53658
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 234 / VA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-02-07
- 2021-02-13
-
2021-02-20
Dose 2 — Moderna
-
2021-02-20
Survey response — 0 day, dose 2MedDRA: Dizziness — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Flatulence — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, 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
-
2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-23
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Diarrhoea, Flushing, Somnolence — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness, Abdominal pain · Be unable to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Flatulence — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-25
- 2021-02-26
- 2021-03-01
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
-
2021-08-21
Survey response — 6 month, dose 2MedDRA: Herpes zoster, Neuralgia, Office visit, Pain, Pustule, Vaccine positive rechallenge — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-08-21
Report sent to call center — 6 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-27
-
2021-08-27
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-21 | Successful 2021-08-27 |
Participant prefers to complete VAERS report online |
Free text
Release 4
Systemic reaction (other): A little light headed/woosie
Systemic reaction (other): Gas
Systemic reaction (other): Yesterday I ate very bland, solid foods. Today I had a lose stool (Im normally constipated) and my intestines are very busy gurgling and talking. Although I have not had a fever in over 24 hours and had very little chills last night, I woke up this morning feeling flush and groggy like I had a fever even though I did not.
Systemic reaction (other): Extreme gas
Release 9
Symptoms: I had an extremely mild case of shingles without a rash on my left back/side after first shot. After the second shot, symptoms returned. Only a few pustules, bad burning nerve pain and traveling pain with touch. My doctor agrees I had Shingles.
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 | Herpes zoster | ✓ | · | ✓ |
| SD | Neuralgia | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Pustule | ✓ | · | ✓ |
| SD | Vaccine positive rechallenge | ✓ | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Flushing | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release