XWS-28031-53294
3 vaccinations
4 coded responses
31 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 802 / CO
- Registered
- 2021-04-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-20
Registered in v-safe
-
2021-04-20
Dose 1 — Moderna
-
2021-04-20
Health check-in — 0 day, dose 1Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
-
2021-04-21
Survey response — days 1–6 daily, dose 1MedDRA: Malaise — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-05-04
- 2021-05-11
-
2021-05-18
Dose 2 — Moderna
- 2021-05-18
-
2021-05-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-05-21
- 2021-05-22
- 2021-05-23
- 2021-05-24
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-06-15
- 2021-06-22
- 2021-06-29
- 2021-08-17
- 2021-11-18
-
2021-12-10
Dose 3 — Moderna
-
2021-12-26
Survey response — 14 day, dose 3MedDRA: Discomfort, Hypersensitivity, Pruritus, Rash, Rash erythematous, Sensitive skin, Skin warm, Swelling, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2021-12-26
Report sent to call center — 14 day, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-27
-
2021-12-27
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2022-01-02
- 2022-01-07
- 2022-01-14
- 2022-01-21
-
2022-03-11
Survey response — 3 month, dose 3MedDRA: Dermatitis contact, Herpes simplex, Office visit, Pruritus, Sensitive skin — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2022-03-11
Report sent to call center — 3 month, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-14
Call successfulReported to VAERS voluntarily prior to GDIT contact
-
2022-06-10
Survey response — 6 month, dose 3MedDRA: Abdominal pain lower, Barrett's oesophagus, Chest discomfort, Dysphagia, Endoscopy abnormal, Office visit, Pain, Throat tightness, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2022-06-10
Report sent to call center — 6 month, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-06-13
-
2022-06-13
Callback requested for02:30PM ET
-
2022-06-13
Call successfulReported to VAERS during previous contact from GDIT
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-20 | Moderna | |
| 2 | 2021-05-18 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-26 | Successful 2021-12-27 |
Reported to VAERS voluntarily prior to GDIT contact |
| 2022-03-11 | Successful 2022-03-14 |
Reported to VAERS voluntarily prior to GDIT contact |
| 2022-06-10 | Successful 2022-06-13 |
Reported to VAERS during previous contact from GDIT |
Free text
Release 7
Systemic reaction (other): Just didnt feel quite 100%
Release 10
Symptoms: Severe widespread itching, red / pink rash, welts and swelling wherever skin is touched, rubbed or gets warm. Very uncomfortable. Started 10 days after booster. Presenting like an allergic reaction to something. Has lasted 5 days so far.
Release 11
Symptoms: Herpetic whitlow with contact dermatitis. Still experiencing major skin sensitivity and itching following Moderna Covid booster 12/10/21. Allergist confirmed symptoms are my immune system overreacting to the booster.
Healthcare visit (other): Plus office visits w/ PCP and allergist
Release 12
Symptoms: GI - Fullness in throat, chest, some difficulty swallowing and more acute pain in lower left abdomen. Endoscopy led to diagnosis of Barrett's Esophagus.
Healthcare visit (other): In person appt, untrasound and endoscopy
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 | Office visit | · | · | ✓ |
| SD | Abdominal pain lower | · | · | ✓ |
| SD | Barrett's oesophagus | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Dermatitis contact | · | · | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Dysphagia | · | · | ✓ |
| SD | Endoscopy abnormal | · | · | ✓ |
| SD | Herpes simplex | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Sensitive skin | · | · | ✓ |
| SD | Skin warm | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Throat tightness | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release