XZW-20671-12665
2 vaccinations
4 coded responses
6 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 921 / CA
- Registered
- 2021-04-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-12
Registered in v-safe
-
2021-04-12
Dose 1 — Moderna
- 2021-04-12
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2021-04-19
Survey response — day 7, dose 1MedDRA: Dysgeusia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Strange taste in mouth all day, like burnt rubberMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-10
Dose 2 — Moderna
-
2021-05-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sore throat, nasal congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-17
Survey response — day 7, dose 2MedDRA: Heavy menstrual bleeding — Feeling: Fair · Headache, Fatigue or tirednessFree text: Issues with period, hard to know if heavy bleeding related to vaccine, had issues after first vaccine where I had heavy bleeding too, not sure if just a separate problem bc Ive been having issues before with periodsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-11-11
Survey response — 6 months, dose 2MedDRA: Asthenia, Back pain, Condition aggravated, Contusion, Erythema, Fatigue, Headache, Menstrual disorder, Paranasal sinus discomfort, Pre-existing disease, Pruritus, Rash, Respiratory disorder, Swelling, Unevaluable event, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Various symptoms.Lots variables so hard to know what related to? Annual flu shot 10/11/21.Very tired,less productive, headache, congested,sinus pressure,flare up joint/back pain, menstrual changes, bruising, neck-rash/hives/redness/itching/swelling. · Healthcare visit (other): Scheduled annual check up this monthMedDRA releases: 2024-11 · check-in free text available
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2021-11-11
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Moderna | |
| 2 | 2021-05-10 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-11 | Unsuccessful |
Free text
Release 7 — day 7, dose 1
Systemic reaction (other): Strange taste in mouth all day, like burnt rubber
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Sore throat, nasal congestion
Release 8 — day 7, dose 2
Systemic reaction (other): Issues with period, hard to know if heavy bleeding related to vaccine, had issues after first vaccine where I had heavy bleeding too, not sure if just a separate problem bc Ive been having issues before with periods
Release 10 — 6 months, dose 2
Symptoms: Various symptoms.Lots variables so hard to know what related to? Annual flu shot 10/11/21.Very tired,less productive, headache, congested,sinus pressure,flare up joint/back pain, menstrual changes, bruising, neck-rash/hives/redness/itching/swelling. cut off by CDC
Healthcare visit (other): Scheduled annual check up this month
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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 | Unevaluable event | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Contusion | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Menstrual disorder | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release