XXT-32110-69684
2 vaccinations
7 coded responses
23 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 068 / CT
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-02
Registered in v-safe
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2021-01-02
Dose 1 — Moderna
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2021-01-02
Health check-in — 0 day, dose 1Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
-
2021-01-04
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Muscle or body achesAdult check-in
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2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: Herpes zoster — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-07
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-09
-
2021-01-16
Survey response — 14 day, dose 1MedDRA: Anxiety, Feeling abnormal, Irritability — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-16
Report sent to call center — 14 day, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-23
- 2021-01-30
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2021-02-02
Dose 2 — Moderna
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2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Heavy menstrual bleeding — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-08
- 2021-02-09
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2021-02-11
Call successfulCompleted over the phone
- 2021-02-16
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2021-02-23
Survey response — 21 day, dose 2MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-02
- 2021-03-09
- 2021-03-16
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2021-05-04
Survey response — 3 month, dose 2MedDRA: Contusion, Epistaxis — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-08-03
- 2022-02-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-02-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-07 | Successful | Completed over the phone |
| 2021-01-16 | Successful 2021-02-11 |
Completed over the phone |
Free text
Release 1
Systemic reaction (other): Suspect new, acute herpes zoster outbreak on left arm
Release 2
Symptoms: Significant anxiety/irritability/brain fog
Release 3
Systemic reaction (other): Sudden onset of severe, heavy menstrual bleeding which is not on schedule and atypical
Systemic reaction (other): Brain fog, an overall feeling of being off. However, I do not feel physically ill with fever, chills or other flu symptoms.
Systemic reaction (other): Minor sore throat
Release 4
Symptoms: Carpal tunnel/median nerve inflammatory response. Lasted 24 hours and was gone. Hadnt experienced this since pregnancy over 6.5 yrs ago. Never experienced fore or after pregnancy except for now a few weeks after vaccination.
Release 8
Symptoms: Nosebleeds and easy bruising
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 | Anxiety | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | Epistaxis | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Irritability | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release