XX7-16067-92122
2 vaccinations
7 coded responses
21 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 923 / CA
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-16
Registered in v-safe
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-31
- 2021-02-06
-
2021-02-12
Dose 2 — Moderna
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Headache, Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: SwellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-19
Survey response — 7 day, dose 2MedDRA: Lymphadenopathy — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-26
- 2021-03-06
-
2021-03-14
Survey response — 28 day, dose 2MedDRA: Arthralgia, Joint swelling — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-20
- 2021-03-26
- 2021-05-14
- 2021-08-13
-
2022-02-12
Survey response — 12 month, dose 2MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, 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
-
2022-02-12
Report sent to call center — 12 month, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-02-16
-
2022-02-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-12 | Successful 2022-02-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4
Systemic reaction (other): These symptoms happened yesterday, but I didn't get a prompt yesterday.
Systemic reaction (other): These symptoms are being reported for 14 Feb 2021
Systemic reaction (other): swollen/tender ipsilateral supraclavicular lymph node (This information is accurate for yesterday, 15 Feb 2021)
Systemic reaction (other): swollen ipsilateral supraclavicular lymph nodes for both today and yesterday
Systemic reaction (other): mildly swollen ipsalateral supraclavicular lymph nodes
Release 5
Symptoms: Mild joint swelling in my right hand, in the index finger and thumb. Somewhat painful.
Release 11
Symptoms: Upper respiratory infection - not COVID confirmed by PCR and antigen test
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Joint swelling | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release