XY2-19046-04382
4 vaccinations
8 coded responses
53 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 805 / CO
- Registered
- 2021-03-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-26
Registered in v-safe
-
2021-03-26
Dose 1 — Moderna
-
2021-03-26
Survey response — 0 day, dose 1MedDRA: Feeling abnormal — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-03-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-29
- 2021-03-30
-
2021-03-31
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-01
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain — Feeling: Fair · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-02
Survey response — 7 day, dose 1MedDRA: Axillary pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-09
- 2021-04-16
-
2021-04-23
Dose 2 — Moderna
- 2021-04-23
-
2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-25
- 2021-04-27
- 2021-04-28
- 2021-04-29
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-07-23
-
2021-10-22
Survey response — 6 month, dose 2MedDRA: Basal cell carcinoma — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2021-10-22
Report sent to call center — 6 month, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2021-11-11
Dose 3 — Moderna
- 2021-11-11
-
2021-11-12
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-25
- 2021-12-02
-
2021-12-09
Survey response — 28 day, dose 3MedDRA: Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-12-16
-
2021-12-24
Survey response — 42 day, dose 3MedDRA: Mass — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2022-02-10
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2022-05-12
Survey response — 6 month, dose 3MedDRA: Blood creatinine increased, Blood pressure increased, Office visit, Trigger finger — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-05-12
Report sent to call center — 6 month, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-11-02
Dose 4 — Pfizer-BioNTech
- 2022-11-02
-
2022-11-03
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
-
2022-11-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-11-05
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2022-11-30
- 2022-12-07
- 2022-12-14
- 2023-02-01
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-11-02 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-22 | Successful 2021-10-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-12 | Successful 2022-05-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 6
Systemic reaction (other): head feels a little foggy
Systemic reaction (other): armpit of arm where I got the shot is very sore
Systemic reaction (other): Armpit is still sore
Systemic reaction (other): armpit still a little sore, but improving
Release 10
Symptoms: basal cell carcinoma
Symptoms: I have mild cold...sore throat & some congestion
Symptoms: I found a lump in my groin but haven't yet made an appointment with my doctor.
Release 11
Symptoms: I was given a steroid shot for 'trigger thumb' Mild increase in blood pressure and creatinine level
Healthcare visit (other): in-office appointments with PCP and specialist
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 | Basal cell carcinoma | · | · | ✓ |
| SD | Blood creatinine increased | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | Mass | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Trigger finger | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release