22C-20140-77587
3 vaccinations
5 coded responses
34 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 770 / TX
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
E4C-92569-11968
Child or adolescent in my care · Female · 2022-06-28
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
- 2021-01-20
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-27
- 2021-02-05
- 2021-02-12
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
- 2021-02-21
-
2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-23
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-24
- 2021-02-25
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-03-29
Survey response — 35 day, dose 2MedDRA: Crohn's disease, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-29
Report sent to call center — 35 day, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-03
- 2021-05-21
-
2021-05-22
Survey response — 3 month, dose 2MedDRA: Kidney infection — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-22
Report sent to call center — 3 month, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-02
Call successfulParticipant prefers to complete VAERS report online
-
2021-08-21
Dose 3 — Moderna
- 2021-08-21
- 2021-08-21
- 2021-08-22
- 2021-08-23
- 2021-08-25
- 2021-08-26
- 2021-08-30
- 2021-09-04
- 2021-09-11
-
2021-09-25
Survey response — 35 day, dose 3MedDRA: Lymphadenopathy, Rhinalgia — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-10-02
- 2021-11-20
- 2022-08-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-08-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-29 | Unsuccessful | |
| 2021-05-22 | Successful 2021-06-02 |
Participant prefers to complete VAERS report online |
Free text
Release 4
Systemic reaction (other): Night sweats each night
Systemic reaction (other): Night sweats
Release 6
Symptoms: Flare of Crohns disease
Release 8
Symptoms: Kidney infection
Release 9
Symptoms: Nose pain, swollen lymph node
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 |
|---|---|---|---|---|
| SD | Crohn's disease | ✓ | ✓ | ✓ |
| SD | Kidney infection | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rhinalgia | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release