XWK-17403-57241
5 vaccinations
16 coded responses
51 check-ins
15 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 479 / IN
- Registered
- 2021-01-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-03
Registered in v-safe
-
2021-01-03
Dose 1 — Moderna
- 2021-01-03
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2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased, Hyperhidrosis — Feeling: Good · Site: ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Hyperhidrosis — Feeling: Fair · Fever · HeadacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-06
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-17
- 2021-01-24
-
2021-01-29
Dose 2 — Moderna
- 2021-02-07
- 2021-02-12
- 2021-02-19
-
2021-02-26
Survey response — 28 day, dose 2MedDRA: Rash, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-26
Report sent to call center — 28 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-05
Survey response — 35 day, dose 2MedDRA: Medical counselling, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-05
Report sent to call center — 35 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-12
- 2021-04-30
- 2021-07-30
- 2021-09-09
-
2021-10-23
Dose 3 — Moderna
-
2021-10-24
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling · Joint pains, Fatigue or tirednessAdult check-in
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2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Swelling · Fatigue or tirednessAdult check-in
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Tinnitus — Feeling: Good · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
- 2021-10-29
-
2021-10-30
Survey response — 7 day, dose 3MedDRA: Tinnitus — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
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2022-01-22
Survey response — 3 month, dose 3MedDRA: Feeling abnormal, Illness, Impaired work ability, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
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2022-04-23
Dose 4 — Moderna
- 2022-04-23
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2022-04-23
Survey response — 0 day, dose 4MedDRA: Fatigue — Feeling: Fair · Joint painsMedDRA releases: 2024-11 · check-in answers available
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2022-04-24
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
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2022-04-25
Survey response — days 1–6 daily, dose 4MedDRA: Pruritus — Feeling: Fair · Site: Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
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2022-04-27
Survey response — days 1–6 daily, dose 4MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
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2022-04-28
Survey response — days 1–6 daily, dose 4MedDRA: Sinus disorder — Feeling: Poor · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
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2022-04-29
Survey response — days 1–6 daily, dose 4MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
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2022-04-30
Survey response — 7 day, dose 4MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2024-11 · check-in answers available
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-06-04
- 2022-07-23
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2022-09-26
Dose 5 — Pfizer-BioNTech
- 2022-10-19
- 2022-10-24
- 2022-10-31
- 2022-11-08
- 2022-12-26
-
2023-03-27
Survey response — 6 month, dose 5MedDRA: Basal cell carcinoma, SARS-CoV-2 test negative, Unevaluable event, Viral infection — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-03 | Moderna | |
| 2 | 2021-01-29 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
| 5 | 2022-09-26 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-26 | Unsuccessful | |
| 2021-03-05 | Unsuccessful |
Free text
Release 1
Systemic reaction (other): Sweaty and heartbeat of 115 BPM earlier today, but I am fine now. I had not been exercising at the time of my measurements.
Systemic reaction (other): Heart rate was normal today, but was sweating again.
Systemic reaction (other): I felt better today.
Release 4
Symptoms: I have a nasty rash, but it hasnt been identified. It is located in multiple places, but worse on the lower part of my left leg.
Healthcare visit (other): I am scheduled for next Monday, March 1, 2021.
Release 5
Symptoms: Rash requiring several medications and prednisone to improve.
Release 10
Systemic reaction (other): ringing in my left ear yes, really it is like having a telephone line.
Systemic reaction (other): I still have the ringing in my ears, but not as bad today.
Release 11
Symptoms: I had some sort of vomiting issue that put me off work 3 days last week. It started at 3 AM on Tuesday morning, and I felt poorly until the Saturday after becoming ill.
Systemic reaction (other): I am tired this afternoon but I am okay.
Systemic reaction (other): Just tire and using some Tylenol.
Systemic reaction (other): Itching
Systemic reaction (other): I did okay today.
Systemic reaction (other): Sinus issues or so aI think.
Systemic reaction (other): I was decent today.
Systemic reaction (other): I do have a rash, but it is more like under the skin's surface maybe hives.
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 | Basal cell carcinoma | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Sinus disorder | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release