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
-
2021-05-28
Dose 1 — Moderna
-
2021-06-29
Dose 2 — Moderna
-
2021-07-11
Registered in v-safe
-
2021-07-11
Health check-in — 7 day, dose 2Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend schoolAdult check-in
- 2021-07-13
- 2021-07-20
-
2021-07-27
Survey response — 28 day, dose 2MedDRA: 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 visitMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-07-27
Report sent to call center — 28 day, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-03
- 2021-08-04
- 2021-08-10
-
2021-09-28
Survey response — 3 month, dose 2MedDRA: 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 visitMedDRA releases: 2024-11 · check-in answers available
-
2021-09-28
Report sent to call center — 3 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-09-30
-
2021-10-01
Call successfulReported to VAERS during previous contact from GDIT
-
2021-12-28
Survey response — 6 month, dose 2MedDRA: 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 visitMedDRA releases: 2024-11 · check-in answers available
-
2021-12-28
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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-29
-
2022-06-29
Survey response — 12 month, dose 2MedDRA: 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 visitMedDRA releases: 2024-11 · check-in answers available
-
2022-06-29
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 · Emergency room or emergency department visit · 1 call case(s)
- 2022-06-30
- 2022-06-30
- 2022-06-30
- 2022-06-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-28 | Moderna | No |
| 2 | 2021-06-29 | Moderna | No |
Call center
| Reported | Outcome | VAERS-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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Dizziness | ✓ | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Immunisation reaction | ✓ | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Nausea | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Photophobia | · | · | ✓ |
| SD | Postural orthostatic tachycardia syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release