XX6-97746-28999
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 890 / NV
- Registered
- 2021-09-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-02
Dose 1 — Moderna
-
2021-09-03
Registered in v-safe
-
2021-09-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-05
-
2021-09-06
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: GoodMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-09-07
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Herpes zoster, Pain, Pre-existing disease, Pruritus, Urinary tract infection — 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
-
2021-09-07
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-08
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Herpes zoster, Rash, 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
-
2021-09-08
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-09
-
2021-09-09
Call successfulParticipant prefers to complete VAERS report online
- 2021-09-16
- 2021-09-23
-
2021-09-30
Dose 2 — Moderna
-
2021-09-30
Health check-in — 0 day, dose 2Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-10-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2021-10-05
- 2021-10-06
- 2021-10-07
- 2021-10-14
- 2021-10-21
- 2021-10-29
- 2021-11-05
- 2021-11-11
- 2021-12-30
- 2022-03-31
- 2022-10-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-02 | Moderna | No |
| 2 | 2021-09-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-07 | Successful | Participant prefers to complete VAERS report online |
| 2021-09-08 | Successful 2021-09-09 |
Participant prefers to complete VAERS report online |
Free text
Release 9
Systemic reaction (other): Constipation. Second day.
Systemic reaction (other): I had shingles 3 weeks ago. Took antibiotics my doctor prescribed. It was all healed. It has now broken back out with a new cluster and itches and hurts. On same side as before but on same side as my covid vaccine on my upper back. Wondering if its r cut off by CDC
Healthcare visit (other): Doctor is out of town but, she will order the viral antibiotics for the new break out of shingles by phone this afternoon. And antibiotics for a new UTI i just came down with in the last 3 days.
Systemic reaction (other): Rash due to shingles, headache due to shingles. Just picked up viral antibiotics so i should start feeling better on that tomorrow
Healthcare visit (other): She ordered more antibiotics
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 | Herpes zoster | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| HCVO | Urinary tract infection | · | · | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Constipation | ✓ | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Herpes zoster | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release