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
-
2021-02-15
Dose 1 — Moderna
-
2021-03-15
Dose 2 — Moderna
-
2021-03-30
Registered in v-safe
- 2021-03-30
-
2021-04-05
Survey response — 21 day, dose 2MedDRA: Oropharyngeal pain, Pyrexia — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-06-14
-
2021-09-16
Survey response — 6 month, dose 2MedDRA: Fatigue, Headache, Pain, Rhinorrhoea, Sneezing, Weight increased — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
-
2021-10-25
Dose 3 — ModernaCo-administered: Flu
- 2021-10-28
- 2021-10-29
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Rhinorrhoea — Feeling: Fair · Muscle or body achesMedDRA releases: 2024-11 · check-in answers available
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
-
2021-11-30
Survey response — 35 day, dose 3MedDRA: Fatigue, Myalgia, Rhinorrhoea — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-12-06
-
2022-01-24
Survey response — 3 month, dose 3MedDRA: Fatigue, Pain, Rhinorrhoea — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
-
2022-04-25
Survey response — 6 month, dose 3MedDRA: 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, HospitalizationMedDRA releases: 2024-11 · check-in answers available
-
2022-04-25
Report sent to call center — 6 month, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-04-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2021-10-25 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Medical observation | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Amnesia | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Transient ischaemic attack | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SD | Weight increased | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release