2TJ-43433-62633
2 vaccinations
3 coded responses
8 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 700 / LA
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Dose 1 — Moderna
-
2021-03-15
Registered in v-safe
-
2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Nervousness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal painFree text: Stomach feels nervous/upsetMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 7, dose 1MedDRA: Anxiety — Feeling: Fair · Fatigue or tiredness, DiarrheaFree text: General feeling of anxiety.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-30
-
2021-04-06
Survey response — day 28, dose 1MedDRA: Foot fracture, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I broke a bone in my right foot. · Healthcare visit (other): Follow up with orthopedicsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-06
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-04-14
Dose 2 — Moderna
- 2021-04-20
- 2021-07-14
- 2022-04-14
- 2022-11-30
-
2022-12-05
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-06 | Successful 2022-12-05 |
Not applicable - Accidental Reporting |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Stomach feels nervous/upset
Release 5 — day 7, dose 1
Systemic reaction (other): General feeling of anxiety.
Release 7 — day 28, dose 1
Symptoms: I broke a bone in my right foot.
Healthcare visit (other): Follow up with orthopedics
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Foot fracture | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Nervousness | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release