XZE-13448-23548
5 vaccinations
4 coded responses
39 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 308 / GA
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-25
Survey response — 7 day, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-30
- 2021-04-06
-
2021-04-13
Dose 2 — Moderna
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-15
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-18
- 2021-04-19
- 2021-04-24
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-19
- 2021-05-25
- 2021-07-13
- 2021-10-12
-
2021-11-22
Dose 3 — Moderna
-
2022-04-01
Dose 4 — Moderna
- 2022-04-13
- 2022-04-13
- 2022-04-16
- 2022-04-22
- 2022-05-01
- 2022-05-08
-
2022-05-13
Survey response — 42 day, dose 4MedDRA: Abdominal pain, Abnormal faeces, Back pain, Flank pain, Nausea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-05-13
Report sent to call center — 42 day, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-16
- 2022-07-01
- 2022-09-30
-
2022-10-03
Dose 5 — ModernaCo-administered: Flu
- 2022-10-18
- 2022-10-24
- 2022-10-31
- 2022-11-16
- 2023-01-02
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-10-03 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-13 | Unsuccessful |
Free text
Release 6
Systemic reaction (other): Rash underneath left breast. It has been there for about 3 days.
Systemic reaction (other): I can not definitively relate or unrelate the rash to the injection. It did appear after I received the injection but could have been caused by a number of things. It has begun to clear up.
Systemic reaction (other): The rash is continuing to clear up.
Release 11
Symptoms: Sharp pains in left side and back. Pain on left side of abdomen. Nausea. Abnormal bowel movement (pebble-like).
Healthcare visit (other): Doctor's office
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 | Abdominal pain | · | · | ✓ |
| SD | Abnormal faeces | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Flank pain | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release