2FA-20663-92312
3 vaccinations
1 coded response
5 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 145 / NY
- Registered
- 2021-12-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
X85-10841-01364
Child or adolescent in my care · Female · 2021-12-21
Timeline
-
2021-02-05
Dose 1 — Moderna
-
2021-03-04
Dose 2 — Moderna
-
2021-12-08
Dose 3 — Moderna
-
2021-12-21
Registered in v-safe
- 2021-12-22
- 2021-12-29
- 2022-01-07
- 2022-01-12
-
2022-01-24
Survey response — day 42, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Uveitis flareMedDRA releases: 2024-11 · check-in free text available
-
2022-01-24
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | No |
| 2 | 2021-03-04 | Moderna | No |
| 3 | 2021-12-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-24 | Unsuccessful |
Free text
Release 11 — day 42, dose 3
Symptoms: Uveitis flare
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 | Condition aggravated | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release