2S3-27084-14111
3 vaccinations
1 coded response
41 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 070 / NJ
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-13
Registered in v-safe
-
2021-04-13
Dose 1 — Moderna
- 2021-04-13
-
2021-04-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-27
- 2021-05-04
-
2021-05-11
Dose 2 — Moderna
- 2021-05-11
-
2021-05-12
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workAdult check-in
-
2021-05-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workAdult check-in
-
2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
-
2021-05-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-06-15
- 2021-06-22
- 2021-08-12
- 2021-11-09
-
2021-11-11
Dose 3 — Moderna
- 2021-11-11
-
2021-11-12
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend schoolAdult check-in
-
2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-14
- 2021-11-15
- 2021-11-16
-
2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache · Be unable to work or attend schoolAdult check-in
- 2021-11-20
- 2021-11-25
- 2021-12-04
- 2021-12-09
- 2021-12-18
- 2021-12-23
- 2022-02-10
- 2022-05-12
-
2022-11-11
Survey response — 12 months, dose 3MedDRA: Delivery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Gave birth.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-11
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-11-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Moderna | |
| 2 | 2021-05-11 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-11 | Successful 2022-11-14 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 12 months, dose 3
Symptoms: Gave birth.
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 | Delivery | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release