XWP-87813-28241
4 vaccinations
4 coded responses
17 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 913 / CA
- Registered
- 2021-04-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-04-13
Dose 2 — Moderna
-
2021-04-22
Registered in v-safe
-
2021-04-22
Survey response — 7 day, dose 2MedDRA: Herpes zoster — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-29
Survey response — 14 day, dose 2MedDRA: Fatigue, Headache, Herpes zoster, Pain, Pyrexia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, 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
-
2021-04-29
Report sent to call center — 14 day, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-04
Survey response — 21 day, dose 2MedDRA: Herpes zoster — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-25
- 2021-07-15
- 2021-10-14
-
2021-11-30
Dose 3 — Moderna
- 2022-04-12
- 2022-04-15
- 2022-04-17
- 2022-04-18
-
2022-05-12
Dose 4 — Moderna
- 2022-05-18
- 2022-05-21
- 2022-05-26
- 2022-06-02
- 2022-06-11
- 2022-06-18
- 2022-06-23
-
2022-08-11
Survey response — 3 month, dose 4MedDRA: Cough, Fatigue, Headache, Nasal congestion, Nasopharyngitis, Pain, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2022-08-11
Report sent to call center — 3 month, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-08-12
- 2022-08-12
- 2022-11-15
- 2023-05-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-11-30 | Moderna | No |
| 4 | 2022-05-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-29 | Unsuccessful | |
| 2022-08-11 | Unsuccessful |
Free text
Release 7
Systemic reaction (other): Have shingles
Release 8
Symptoms: Still struggling w/ Shingles which develp'd prior to 2nd vax but not diagnosed until after 2nd dose was rec'd. Been homebound since 4/13 vax first suffering from typical post vax reactions (101° , headache, fatigue) then from SEVERE Shingles pain et cut off by CDC
Symptoms: Continue to suffer from Shingles which developed between first and second vaccine.
Release 12
Symptoms: Tested positive for covid 5 days ago. Symptoms included those of a bad cold-extreme nasal congestion, runny nose, mild cough and headache but with fatigue and mild achiness.
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 | Cough | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ○ | ○ | ○ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release