273-31239-00402
4 vaccinations
5 coded responses
31 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 930 / CA
- Registered
- 2021-03-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-20
Registered in v-safe
-
2021-03-20
Dose 1 — Moderna
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: Pain · Be unable to do your normal daily activitiesFree text: Sore upper arm only. (Injected arm)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-11
-
2021-04-17
Dose 2 — Moderna
- 2021-04-17
-
2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: This report is for 4/18/2021 as I missed the check in for the day after my 2nd vaccination...which was 4/17/21 my symptoms lasted only 1 day and today I am back to normal and happy to have had the vaxxine :)1.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-20
- 2021-04-21
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal discomfort, Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Abdominal painFree text: Slight sore throat and feels like swollen glands in neck. Also having some stomache discomfort.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Cholecystectomy, Cholecystitis infective, Cholelithiasis, Hospitalisation — Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · 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, HospitalizationFree text: Hospitalized for gallbladder infection with stones. Gallbladder removed 4-23 -21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — days 1–6 daily, 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)
-
2021-04-24
Survey response — day 7, dose 2MedDRA: Emergency care, Hospitalisation — Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Systemic reaction (other): Hospitalized Gallbladder removal. · Healthcare visit (other): ER also but on Friday 4/23/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-24
Report sent to call center — day 7, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-07-17
- 2021-10-17
-
2021-11-17
Dose 3 — Moderna
- 2022-02-04
-
2022-02-04
Call successfulDoes not wish to fill out VAERS report
-
2022-04-01
Dose 4 — Moderna
- 2022-04-17
- 2022-04-26
- 2022-04-29
- 2022-05-08
- 2022-05-13
- 2022-07-01
- 2022-09-30
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
Call center
2 call center cases
2 successful
1 wait over 3 months for a first call
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Sore upper arm only. (Injected arm)
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): This report is for 4/18/2021 as I missed the check in for the day after my 2nd vaccination...which was 4/17/21 my symptoms lasted only 1 day and today I am back to normal and happy to have had the vaxxine :)1.
Systemic reaction (other): Slight sore throat and feels like swollen glands in neck. Also having some stomache discomfort.
Systemic reaction (other): Hospitalized for gallbladder infection with stones. Gallbladder removed 4-23 -21.
Release 7 — day 7, dose 2
Systemic reaction (other): Hospitalized Gallbladder removal.
Healthcare visit (other): ER also but on Friday 4/23/21
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 | Emergency care | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Cholecystectomy | ✓ | ✓ | ✓ |
| SRO | Cholecystitis infective | ✓ | ✓ | ✓ |
| SRO | Cholelithiasis | ✓ | ✓ | ✓ |
| SRO | Hospitalisation | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release