XWV-11347-73627
2 vaccinations
6 coded responses
25 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 342 / FL
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
-
2021-03-16
Survey response — 0 day, dose 1MedDRA: Feeling abnormal — Feeling: Good · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Muscle or body achesAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-23
-
2021-03-30
Survey response — 14 day, dose 1MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-08
-
2021-04-13
Dose 2 — Moderna
- 2021-04-13
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-04-18
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-21
Survey response — 7 day, dose 2MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-27
-
2021-05-05
Survey response — 21 day, dose 2MedDRA: Back pain — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-11
-
2021-05-18
Survey response — 35 day, dose 2MedDRA: Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-25
-
2021-07-13
Survey response — 3 month, dose 2MedDRA: Office visit, Sinus pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-07-13
Report sent to call center — 3 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
- 2021-10-12
- 2022-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-13 | Unsuccessful |
Free text
Release 5
Systemic reaction (other): Just feel a little differently.
Release 6
Symptoms: Nerve related sensing when sitting or lying. Feels like when we express my finger is going asleep.
Release 7
Systemic reaction (other): Just feel different, hard to describe.
Release 8
Symptoms: I have back issues. Back pain increased after the 1st shot. Same after 2nd shot. It might not have any connection, but all my nerves seemed to be more sensitive after shots.
Symptoms: Back has been keeping me from normal schedule. Seems like nerves are more sensitive since shots.
Release 9
Symptoms: Sinus pain. MD scheduled to do scan Monday.
Healthcare visit (other): Doctor in-person appointment.
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Sinus pain | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release