35W-43279-25667
3 vaccinations
4 coded responses
19 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 670 / KS
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-22
Registered in v-safe
- 2021-01-22
-
2021-01-29
Survey response — day 21, dose 1MedDRA: Cough, Influenza virus test negative, Lymphadenopathy, Nasal congestion, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Sore throat, enlarged lymph nodes, cough, nasal, head, and chest congestion · Healthcare visit (other): Negative test for covid, flu, and strepMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-05
Dose 2 — Moderna
- 2021-02-05
-
2021-02-06
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, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-10
- 2021-02-11
-
2021-02-19
Survey response — day 14, dose 2MedDRA: Lymph node pain — Feeling: GoodFree text: Lymph node tenderness in left breast/armpit area for 3-4 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-25
- 2021-08-06
-
2021-10-23
Dose 3 — Moderna
- 2021-10-25
- 2021-10-26
- 2021-10-30
- 2021-11-06
-
2021-11-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-15
- 2021-11-28
- 2021-12-06
-
2022-01-22
Survey response — 3 months, dose 3MedDRA: COVID-19, Cough, Headache, Pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Covid + with headache, body aches, cough, chest and head congestion, runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Survey response — 6 months, dose 3MedDRA: Nausea, Pregnancy, Vomiting — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Extreme nausea and vomiting due to pregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-04-27
-
2022-05-02
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 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-29 | Successful 2021-11-06 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-04-23 | Successful 2022-05-02 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 3 — day 21, dose 1
Symptoms: Sore throat, enlarged lymph nodes, cough, nasal, head, and chest congestion
Healthcare visit (other): Negative test for covid, flu, and strep
Release 4 — day 14, dose 2
Symptoms: Lymph node tenderness in left breast/armpit area for 3-4 days
Release 11 — 3 months, dose 3
Symptoms: Covid + with headache, body aches, cough, chest and head congestion, runny nose
Release 11 — 6 months, dose 3
Symptoms: Extreme nausea and vomiting due to pregnancy
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 | Influenza virus test negative | ✓ | ✓ | ✓ |
| HCVO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Lymph node pain | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release