XYX-57213-70676
2 vaccinations
9 coded responses
25 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 128 / NY
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
-
2021-02-13
Health check-in — 0 day, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Stomatitis — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Stomatitis — Feeling: Fair · Site: Pain · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Respiratory tract congestion, Rhinorrhoea, Stomatitis — Feeling: Good · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
- 2021-03-06
-
2021-03-13
Dose 2 — Moderna
- 2021-03-13
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: SARS-CoV-2 test negative — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · 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
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2021-03-16
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Fair · Site: Itching · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Lymphadenopathy — Feeling: Good · Site: Itching · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-20
Survey response — 7 day, dose 2MedDRA: Lymphadenopathy — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-06-12
- 2021-09-11
- 2021-12-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-16 | Unsuccessful |
Free text
Release 4
Systemic reaction (other): Several sores have popped up in my mouth that were not there yesterday.
Systemic reaction (other): Sores in my mouth
Systemic reaction (other): Slight congestion/runny nose. Continue to have sores in my mouth that seem to be healing.
Release 5
Systemic reaction (other): Swollen lymph nodes in neck and armpit areas
Healthcare visit (other): Rapid test negative for Covid! Send out also done.
Systemic reaction (other): Swollen lymph nodes along collar bone and under arm pit.
Systemic reaction (other): STILL have very swollen lymph nodes along collar bone and armpit, as well as back pain.
Systemic reaction (other): Still have swollen lymph nodes along collar bone! 6 days post vaccine!
Release 6
Systemic reaction (other): Swollen lymph nodes along collar bone and armpit
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 | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Stomatitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release