363-27369-36690
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 921 / CA
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Dose 1 — Moderna
-
2020-12-30
Registered in v-safe
- 2020-12-30
- 2021-01-01
- 2021-01-02
-
2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Lymphadenopathy — Feeling: GoodFree text: Lymphadenopathy in left axilla, same side as the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Lymph node pain — Feeling: GoodFree text: Painful axillary lymph node on same side as shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-05
Survey response — day 7, dose 1MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, SwellingFree text: Painful lymphadenopathyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-12
- 2021-01-22
- 2021-01-26
-
2021-01-30
Dose 2 — Moderna
- 2021-01-30
-
2021-01-31
Survey response — days 1–6 daily, dose 2MedDRA: Maternal exposure during breast feeding — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: My child whom I'm breastfeeding also had symptoms of pain at the same time my symptoms startedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-05-01
- 2021-07-31
-
2022-01-30
Survey response — 12 months, dose 2MedDRA: Bronchitis, Headache, Pregnancy, Sinusitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection, headache, bronchitis, currently pregnant.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-30
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-30 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-30 | Unsuccessful |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Lymphadenopathy in left axilla, same side as the shot
Systemic reaction (other): Painful axillary lymph node on same side as shot
Release 1 — day 7, dose 1
Systemic reaction (other): Painful lymphadenopathy
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): My child whom I'm breastfeeding also had symptoms of pain at the same time my symptoms started
Release 11 — 12 months, dose 2
Symptoms: Sinus infection, headache, bronchitis, currently pregnant.
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 | Bronchitis | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Maternal exposure during breast feeding | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release