287-47840-77461
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 494 / MI
- Registered
- 2021-01-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
48M-19580-39705
Child or adolescent in my care · Male · 2022-06-30
UJN-70634-46289
Child or adolescent in my care · Female · 2022-06-30
ZLQ-54693-91485
Child or adolescent in my care · Male · 2022-09-10
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-10
Registered in v-safe
-
2021-01-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-01-11
- 2021-01-12
- 2021-01-13
-
2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Good · HeadacheFree text: Congestion/stuffy noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-15
Survey response — day 7, dose 1MedDRA: Respiratory tract congestion — Feeling: GoodFree text: CongestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-22
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
-
2021-02-05
Survey response — day 0, dose 2MedDRA: Vertigo — Feeling: Good · Site: PainFree text: VertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-07
-
2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-13
- 2021-03-19
-
2021-05-07
Survey response — 3 months, dose 2MedDRA: Norovirus infection — Feeling: Good · Be unable to workFree text: NorovirusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-06
-
2022-02-05
Survey response — 12 months, dose 2MedDRA: Hepatitis A, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Pregnancy Hepatitis AMedDRA releases: 2024-11 · check-in free text available
-
2022-02-05
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-05 | Successful 2022-03-16 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Congestion/stuffy nose
Release 2 — day 7, dose 1
Systemic reaction (other): Congestion
Release 3 — day 0, dose 2
Systemic reaction (other): Vertigo
Release 8 — 3 months, dose 2
Symptoms: Norovirus
Release 11 — 12 months, dose 2
Symptoms: Pregnancy Hepatitis A
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 |
|---|---|---|---|---|
| SD | Hepatitis A | · | · | ✓ |
| SD | Norovirus infection | ✓ | ✓ | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release