2Y6-12781-86330
3 vaccinations
3 coded responses
21 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 857 / AZ
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-11
-
2021-02-16
Survey response — day 28, dose 1MedDRA: Anxiety, Eye pruritus, Insomnia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Trouble sleeping, itchy eyes, anxiety.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Dose 2 — Moderna
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-12
- 2021-03-19
- 2021-03-25
- 2021-03-31
-
2021-05-19
Survey response — 3 months, dose 2MedDRA: Tooth infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Tooth infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-19
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-18
-
2022-01-02
Dose 3 — Moderna
- 2022-02-17
- 2022-02-17
-
2022-04-03
Survey response — 3 months, dose 3MedDRA: Back pain, Pruritus — Feeling: FairFree text: Back pain, itchy skinMedDRA releases: 2024-11 · check-in free text available
- 2022-05-11
- 2022-07-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2022-01-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-19 | Unsuccessful |
Free text
Release 4 — day 28, dose 1
Symptoms: Trouble sleeping, itchy eyes, anxiety.
Release 8 — 3 months, dose 2
Symptoms: Tooth infection
Release 11 — 3 months, dose 3
Symptoms: Back pain, itchy skin
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 | Anxiety | ✓ | ✓ | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Eye pruritus | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Tooth infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release