XXN-23975-16894
5 vaccinations
8 coded responses
41 check-ins
8 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 935 / CA
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-02
Registered in v-safe
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
-
2021-04-21
Survey response — 21 day, dose 1MedDRA: Headache, Injection site pain, Pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-28
Dose 2 — Moderna
- 2021-04-28
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-21
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-07-28
-
2021-08-31
Dose 3 — Moderna
- 2021-10-27
-
2021-12-01
Survey response — 3 month, dose 3MedDRA: Oropharyngeal pain — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2022-03-01
-
2022-03-22
Dose 4 — Moderna
-
2022-06-22
Survey response — 3 month, dose 4MedDRA: Brain fog, Disturbance in attention, Sensory overload, Spinal stenosis — Feeling: Poor · 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
-
2022-06-22
Report sent to call center — 3 month, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-06-22
Call successfulNot applicable - Accidental Reporting
-
2022-09-21
Survey response — 6 month, dose 4MedDRA: Aphasia, Brain fog, Dysarthria, Fatigue — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
-
2022-09-26
Dose 5 — Moderna
- 2022-09-26
-
2022-09-27
Survey response — days 1–6 daily, dose 5MedDRA: Physiotherapy — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-09-27
Report sent to call center — days 1–6 daily, dose 5Get care from a doctor or other healthcare professional1 call case(s)
-
2022-09-28
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-09-28
Call successfulParticipant prefers to complete VAERS report online
- 2022-09-29
- 2022-09-30
- 2022-10-01
-
2022-10-02
Survey response — days 1–6 daily, dose 5MedDRA: Brain fog — Feeling: Good · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
-
2022-10-03
Survey response — 7 day, dose 5MedDRA: Brain fog — Feeling: Good · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
-
2022-12-26
Survey response — 3 month, dose 5MedDRA: Body temperature increased, Rhinorrhoea, Sneezing — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-08-31 | Moderna | No |
| 4 | 2022-03-22 | Moderna | No |
| 5 | 2022-09-26 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-22 | Successful 2022-06-22 |
Not applicable - Accidental Reporting |
| 2022-09-27 | Successful 2022-09-28 |
Participant prefers to complete VAERS report online |
Free text
Release 7
Symptoms: Headache, muscle aches, mild pain at injection site. Lasted about 12 hours then went away. Feel back to normal now.
Release 10
Symptoms: Sore throat
Release 12
Symptoms: Brain fog Sensory overload Increased difficulty in concentration Spinal stenosis (unrelated to COVID)
Healthcare visit (other): Outpatient steroid Injection for spinal stenosis unrelated to COVID.
Symptoms: Fatigue, difficulty recalling words, brain fog, slurring words
Healthcare visit (other): Physical Therapy
Systemic reaction (other): I've been forgetting to report brain fog
Systemic reaction (other): Brain fog
Symptoms: Runny nose, sneezing, 99 temperature
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 | Physiotherapy | · | · | ✓ |
| HCVO | Spinal stenosis | · | · | ✓ |
| SD | Aphasia | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Dysarthria | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sensory overload | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Spinal stenosis | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release