342-12836-44193
4 vaccinations
4 coded responses
42 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 460 / IN
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-15
Registered in v-safe
-
2021-04-15
Dose 1 — Moderna
-
2021-04-15
Survey response — day 0, dose 1MedDRA: Tinnitus — Feeling: Good · Site: Pain · HeadacheFree text: Ringing in EarsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Good · Site: Pain, Swelling · HeadacheFree text: Ringing earsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-05-13
Dose 2 — Moderna
- 2021-05-13
-
2021-05-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-20
- 2021-05-28
- 2021-06-03
- 2021-06-18
- 2021-06-24
- 2021-08-12
- 2021-11-14
-
2021-12-09
Dose 3 — Moderna
- 2021-12-09
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-14
- 2021-12-15
- 2021-12-16
-
2021-12-25
Survey response — day 14, dose 3MedDRA: Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: HivesMedDRA releases: 2024-11 · check-in free text available
-
2021-12-25
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-27
- 2021-12-30
- 2022-01-25
- 2022-03-10
- 2022-06-09
-
2022-09-30
Dose 4 — ModernaCo-administered: Flu
-
2022-10-01
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-02
- 2022-10-03
-
2022-10-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-05
- 2022-10-06
- 2022-10-07
-
2022-10-24
Survey response — day 21, dose 4MedDRA: Caesarean section — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: C SectionMedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Report sent to call center — day 21, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-10-25
- 2022-10-25
- 2022-10-29
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna | |
| 3 | 2021-12-09 | Moderna | No |
| 4 | 2022-09-30 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-25 | Unsuccessful | |
| 2022-10-24 | Unsuccessful |
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): Ringing in Ears
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Ringing ears
Release 10 — day 14, dose 3
Symptoms: Hives
Release 12 — day 21, dose 4
Symptoms: C Section
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 | Caesarean section | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release