XY4-11052-52189
2 vaccinations
3 coded responses
21 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 376 / TN
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
- 2021-01-28
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
-
2021-02-15
Survey response — 21 day, dose 1MedDRA: Headache, Nausea, Pain — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-22
Dose 2 — Moderna
- 2021-02-22
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-03
- 2021-03-08
- 2021-03-15
- 2021-03-23
-
2021-05-24
Survey response — 3 month, dose 2MedDRA: Headache, Office visit, Reaction to previous exposure to any vaccine — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-24
Report sent to call center — 3 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-24
-
2022-02-22
Survey response — 12 month, dose 2MedDRA: Office visit, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-02-22
Report sent to call center — 12 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-02-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-22 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-24 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-02-22 | Successful 2022-02-23 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4
Symptoms: Head aches, nausea, body aches
Release 8
Symptoms: Frequent headaches originating in the back of head I had these symptoms as i reported the first days after 1st and 2nd dose but they subsided after 5-7 days. Present headaches started about 6 weeks ago & were occurring daily. Had ct brain scan/negati cut off by CDC
Healthcare visit (other): PC ordered ct scan and blood work out patient. BW ok snd scan negative. Referral to ENT specialist
Release 11
Symptoms: Upper respiratory infection Covid test negative
Healthcare visit (other): PCP
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 | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release