XWB-11247-82848
2 vaccinations
11 coded responses
19 check-ins
11 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 100 / NY
- Registered
- 2021-08-18
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
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2021-08-18
Registered in v-safe
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2021-08-18
Dose 1 — Moderna
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2021-08-19
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Fatigue, Insomnia — Feeling: Fair · Site: PainMedDRA releases: 2021-09,2024-11 · check-in answers available
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2021-08-20
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Sleep deficit — Feeling: Good · Site: Pain · Fatigue or tirednessMedDRA releases: 2021-09,2024-11 · check-in answers available
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2021-08-22
Survey response — days 1–6 daily, dose 1MedDRA: Vaccination site pain — Feeling: GoodMedDRA releases: 2021-09,2024-11 · check-in answers available
- 2021-08-23
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2021-08-25
Survey response — 7 day, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: FairMedDRA releases: 2021-09,2024-11 · check-in answers available
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2021-09-01
Survey response — 14 day, dose 1MedDRA: Discomfort, Lymphadenopathy — Feeling: GoodMedDRA releases: 2021-09,2024-11 · check-in answers available
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2021-09-09
Survey response — 21 day, dose 1MedDRA: Burning sensation, Discomfort, Lymphadenopathy — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
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2021-09-15
Dose 2 — Moderna
- 2021-09-15
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2021-09-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-09-17
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue, Impaired work ability, Self-medication — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
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2021-09-20
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pruritus — Feeling: Good · Site: ItchingMedDRA releases: 2024-11 · check-in answers available
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2021-09-22
Survey response — 7 day, dose 2MedDRA: Injection site pruritus — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-09-29
- 2021-10-08
- 2021-10-13
- 2021-10-20
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2021-10-27
Survey response — 42 day, dose 2MedDRA: Fatigue, Pain, SARS-CoV-2 test negative — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-12-15
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2022-03-17
Survey response — 6 month, dose 2MedDRA: Cardiac disorder — 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 · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11 · check-in answers available
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2022-03-17
Report sent to call center — 6 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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-03-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-18 | Moderna | No |
| 2 | 2021-09-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-17 | Successful 2022-03-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 9
Systemic reaction (other): Last night I was fatigued and had a mild cough at bed time. The cough went away and didnt keep me up. The fatigue today may be from over working and lack of sleep
Systemic reaction (other): Im still sleep deprived so I cant blame fatigue solely on vaccine
Systemic reaction (other): Pain diminishes at vaccination site its basically gone now
Systemic reaction (other): Tender slightly swollen lymph nodes Deep in armpit where injection site was right arm.
Symptoms: I had swollen lymph nodes deep in my right armpit a few days after shot. Its improved and subsided, but it still hasnt fully gone beck to normal. There is slight discomfort no swelling a very subtle similarity on my left armpit. Its taking l
Symptoms: I still have slight discomfort in my lymph nodes. Feels like slight swelling mild occasional burning. This started a few days after shot and hasnt gone away. Its minor but persistent.
Systemic reaction (other): Yesterday I stated off feeling fine but got chills and fatigue by the end of the day. I had to leave early from work but almost made it through the day completely. Slept it off with some alieve and gator aid.
Systemic reaction (other): Very minor itching at injection site. Started a day or two ago
Systemic reaction (other): Mild itching at injection site is reduced a lot. Getting better by the day
Release 10
Symptoms: Minor Chronic fatigue and an increase of steady aches. It's minor but persistent. I have tested for Covid more than once. It's not that. This has lasted for at least a month.
Release 11
Symptoms: Had an issue with my heart, but so far it seems to be nothing important. Just a scare so far.
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 | Burning sensation | · | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Discomfort | ✓ | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Cough | ✓ | · | ✓ |
| SRO | Fatigue | ✓ | · | ✓ |
| SRO | Impaired work ability | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | Insomnia | ✓ | · | ✓ |
| SRO | Lymph node pain | ✓ | · | ✓ |
| SRO | Lymphadenopathy | ✓ | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Sleep deficit | ✓ | · | ✓ |
| SRO | Vaccination site pain | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release