XWM-19273-13635
4 vaccinations
3 coded responses
31 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 303 / GA
- Registered
- 2021-03-26
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-26
Registered in v-safe
-
2021-03-26
Dose 1 — Moderna
- 2021-03-26
-
2021-03-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
-
2021-04-23
Dose 2 — Moderna
- 2021-04-23
-
2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-04-28
- 2021-04-29
- 2021-04-30
-
2021-05-07
Survey response — day 14, dose 2MedDRA: Tinnitus — Feeling: GoodFree text: Intermittent tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-07-25
- 2021-10-22
-
2021-12-17
Dose 3 — Moderna
-
2022-04-23
Survey response — 12 months, dose 2MedDRA: Bell's palsy — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Bell's palsyMedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-04-25
-
2022-09-17
Dose 4 — Moderna
- 2022-09-30
- 2022-10-01
- 2022-10-10
-
2022-12-18
Survey response — 3 months, dose 4MedDRA: Hypertension, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tinnitus, high blood pressureMedDRA releases: 2024-11 · check-in free text available
-
2022-12-18
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-19
- 2022-12-19
-
2022-12-21
Call successfulDoes not wish to fill out VAERS report
-
2022-12-21
Call successfulParticipant prefers to complete VAERS report online
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-12-17 | Moderna | No |
| 4 | 2022-09-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-23 | Successful 2022-12-21 |
Does not wish to fill out VAERS report |
| 2022-12-18 | Successful 2022-12-21 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — day 14, dose 2
Symptoms: Intermittent tinnitus
Release 11 — 12 months, dose 2
Symptoms: Bell's palsy
Release 12 — 3 months, dose 4
Symptoms: Tinnitus, high blood pressure
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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 | Bell's palsy | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release