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XZ2-12506-86730

3 vaccinations 6 coded responses 19 check-ins 6 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
220 / VA
Registered
2021-03-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-15
    Dose 1 — Moderna
  2. 2021-03-15
    Dose 2 — Moderna
  3. 2021-03-30
    Registered in v-safe
  4. 2021-03-30
    Health check-in — 14 day, dose 2
    Feeling: Good
    Adult check-in
  5. 2021-04-05
    Survey response — 21 day, dose 2
    MedDRA: Oropharyngeal pain, Pyrexia — Feeling: Fair
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  6. 2021-04-12
    Health check-in — 28 day, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-04-19
    Health check-in — 35 day, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-04-26
    Health check-in — 42 day, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-06-14
    Health check-in — 3 month, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-09-16
    Survey response — 6 month, dose 2
    MedDRA: Fatigue, Headache, Pain, Rhinorrhoea, Sneezing, Weight increased — Feeling: Good
    MedDRA releases: 2024-11 · check-in answers available
  11. 2021-10-25
    Dose 3 — Moderna
    Co-administered: Flu
  12. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  13. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  14. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  15. 2021-10-31
    Survey response — days 1–6 daily, dose 3
    MedDRA: Rhinorrhoea — Feeling: Fair · Muscle or body aches
    MedDRA releases: 2024-11 · check-in answers available
  16. 2021-11-01
    Health check-in — 7 day, dose 3
    Feeling: Good · Muscle or body aches
    Adult check-in
  17. 2021-11-08
    Health check-in — 14 day, dose 3
    Feeling: Good
    Adult check-in
  18. 2021-11-15
    Health check-in — 21 day, dose 3
    Feeling: Good
    Adult check-in
  19. 2021-11-22
    Health check-in — 28 day, dose 3
    Feeling: Good
    Adult check-in
  20. 2021-11-30
    Survey response — 35 day, dose 3
    MedDRA: Fatigue, Myalgia, Rhinorrhoea — Feeling: Good
    MedDRA releases: 2024-11 · check-in answers available
  21. 2021-12-06
    Health check-in — 42 day, dose 3
    Feeling: Fair
    Adult check-in
  22. 2022-01-24
    Survey response — 3 month, dose 3
    MedDRA: Fatigue, Pain, Rhinorrhoea — Feeling: Fair
    MedDRA releases: 2024-11 · check-in answers available
  23. 2022-04-25
    Survey response — 6 month, dose 3
    MedDRA: Amnesia, Atrial fibrillation, Medical observation, Office visit, Transient ischaemic attack, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization
    MedDRA releases: 2024-11 · check-in answers available
  24. 2022-04-25
    Report sent to call center — 6 month, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  25. 2022-04-26
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-02-15Moderna
22021-03-15Moderna
32021-10-25Moderna Flu

Call center

ReportedOutcomeVAERS-related outcome
2022-04-25 Successful
2022-04-26
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6

Symptoms: Fever for 1 day. Occasional sore throat.

Release 9

Symptoms: Gained weight. Get more tired and sore playing golf. When through a stretch of dail headaches for 3 or 4 days. Snezzing and slight runny nose sometimes. However, temperature and oxygen levels have been good.

Release 10

Systemic reaction (other): Runny nose

Symptoms: Muscle aches, occasional sniffles, fatigue

Release 11

Symptoms: Tiredness.. Body aches. Occasional slight runny nose.

Symptoms: TIAs leading to some loss of short term memory. Problem with vision which has returned normal. Apparently, AFIB caused this. Given a choice, I have elected to stay in AFIB for now.
Healthcare visit (other): Vsrious doctors. MRI. CT scan. 48 houer ambulatory EEG, etc.

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

FieldPreferred term2021-092023-042024-11
HCVOMedical observation · · ✓
HCVOOffice visit · · ✓
SDAmnesia · · ✓
SDAtrial fibrillation · · ✓
SDFatigue · · ✓
SDHeadache · · ✓
SDMyalgia · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain · · ✓
SDPyrexia ✓ ✓ ✓
SDRhinorrhoea · · ✓
SDSneezing · · ✓
SDTransient ischaemic attack · · ✓
SDVisual impairment · · ✓
SDWeight increased · · ✓
SRORhinorrhoea · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release