XXE-87137-18197
3 vaccinations
6 coded responses
23 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 493 / MI
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-03-18
Registered in v-safe
-
2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-21
-
2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Back pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-23
Survey response — 7 day, dose 1MedDRA: Arthralgia, Colitis, Irritable bowel syndrome, Psoriatic arthropathy — Feeling: Good · Joint pains, Abdominal painMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-30
-
2021-04-06
Survey response — 21 day, dose 1MedDRA: Cough — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-13
Dose 2 — Moderna
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint painsAdult check-in
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-14
-
2021-10-12
Survey response — 6 month, dose 2MedDRA: Malaise, SARS-CoV-2 test negative, Viral 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 · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2021-10-12
Report sent to call center — 6 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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-09
Dose 3 — Moderna
-
2022-04-13
Survey response — 12 month, dose 2MedDRA: Arthralgia, Inflammation, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-04-13
Report sent to call center — 12 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-14
-
2022-04-15
Callback requested for10:00AM ET
-
2022-04-15
Call successfulParticipant prefers to complete VAERS report online
- 2022-11-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-12 | Successful 2021-10-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-04-13 | Successful 2022-04-15 |
Participant prefers to complete VAERS report online |
Free text
Release 6
Systemic reaction (other): I've had a back ache and joint pain a little worse then normal but have been walking and cleaning the yard. So think that is it
Systemic reaction (other): Just the joint pains but think it's my IBS/Colitis and psoriatic arthritis they haven't bothered me in a while so not sure if vaccine has anything to do with it I'm hoping not because don't want a second vaccine to really flare it up.
Release 7
Symptoms: I aspirated a cracker so hope it's just that but have developed a cough
Systemic reaction (other): I got the vaccine Tuesday and Wednesday I had a fever 102 and felt worst then today. Thought maybe it's because I'm on a antibiotic for a bladder/kidney infection
Release 10
Symptoms: I got sick with a virus but tested negative for Covid.
Release 11
Symptoms: Hip joint pain and big toe inflammation
Healthcare visit (other): I seen a podiatrist
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 | Arthralgia | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Colitis | ✓ | ✓ | ✓ |
| SRO | Irritable bowel syndrome | ✓ | ✓ | ✓ |
| SRO | Psoriatic arthropathy | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release