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XXH-31688-27519

2 vaccinations 4 coded responses 9 check-ins 4 free-text entries 4 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
972 / OR
Registered
2021-07-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-05-28
    Dose 1 — Moderna
  2. 2021-06-29
    Dose 2 — Moderna
  3. 2021-07-11
    Registered in v-safe
  4. 2021-07-11
    Health check-in — 7 day, dose 2
    Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school
    Adult check-in
  5. 2021-07-13
    Health check-in — 14 day, dose 2
    Feeling: Poor
    Adult check-in
  6. 2021-07-20
    Health check-in — 21 day, dose 2
    Feeling: Fair
    Adult check-in
  7. 2021-07-27
    Survey response — 28 day, dose 2
    MedDRA: Dizziness, Immunisation reaction, Nausea, Office visit — Feeling: Poor · 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 consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2021-09,2024-11 · check-in answers available
  8. 2021-07-27
    Report sent to call center — 28 day, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  9. 2021-08-03
    Health check-in — 35 day, dose 2
    Feeling: Poor
    Adult check-in
  10. 2021-08-04
  11. 2021-08-10
    Health check-in — 42 day, dose 2
    Feeling: Poor
    Adult check-in
  12. 2021-09-28
    Survey response — 3 month, dose 2
    MedDRA: Fatigue, Headache, Nausea — Feeling: Poor · 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 consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11 · check-in answers available
  13. 2021-09-28
    Report sent to call center — 3 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  14. 2021-09-30
  15. 2021-10-01
    Call successful
    Reported to VAERS during previous contact from GDIT
  16. 2021-12-28
    Survey response — 6 month, dose 2
    MedDRA: Dizziness, Headache, Impaired work ability, Loss of personal independence in daily activities, Nausea, Photophobia, Unevaluable event — Feeling: Poor · 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 consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11 · check-in answers available
  17. 2021-12-28
    Report sent to call center — 6 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  18. 2021-12-29
  19. 2022-06-29
    Survey response — 12 month, dose 2
    MedDRA: Postural orthostatic tachycardia syndrome — Feeling: Poor · 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 consultation, Emergency room or emergency department visit
    MedDRA releases: 2024-11 · check-in answers available
  20. 2022-06-29
    Report sent to call center — 12 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
  21. 2022-06-30
  22. 2022-06-30
  23. 2022-06-30
  24. 2022-06-30

Vaccinations

DoseDateManufacturerCo-administered
12021-05-28Moderna No
22021-06-29Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-07-27 Successful Completed over the phone
2021-09-28 Successful
2021-10-01
Reported to VAERS during previous contact from GDIT
2021-12-28 Unsuccessful Reported to VAERS during previous contact from GDIT
2022-06-29 Unsuccessful

Free text

Release 9

Symptoms: Dizziness and nausea increased over the past week. Consulting numerous doctors. Not seeing much improvement and I'm now one month out. Very concerned and unable to find answers. Doctors are unfamiliar with such a pronlonged reaction.

Symptoms: Daily headache, nausea and fatigue.

Release 10

Symptoms: Ongoing daily headaches, nausea and dizziness for six months beginning the day after receiving the second dose of Moderna. Light sensitivity has increased over the months making working and conducting daily life extremely difficult
Healthcare visit (other): Scheduled for a lumbar puncture January 10, 2022

Release 12

Symptoms: I have been diagnosed with POTS (postural orthosatic tachycardia syndrome). Owing to the proximity in time that thr symptoms started in relation to the vaccine, I believe there may some correlation (withim 24 hours).

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event · · ✓
SDDizziness ✓ · ✓
SDFatigue · · ✓
SDHeadache · · ✓
SDImmunisation reaction ✓ · ✓
SDImpaired work ability · · ✓
SDLoss of personal independence in daily activities · · ✓
SDNausea ✓ · ✓
SDOffice visit ✓ · ✓
SDPhotophobia · · ✓
SDPostural orthostatic tachycardia syndrome · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release