36Z-18113-22870
3 vaccinations
2 coded responses
3 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 972 / OR
- Registered
- 2021-12-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Dose 1 — Moderna
-
2021-02-17
Dose 2 — Moderna
-
2021-12-02
Dose 3 — ModernaCo-administered: Flu
-
2021-12-18
Registered in v-safe
-
2021-12-18
Survey response — day 14, dose 3MedDRA: Abortion spontaneous — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I had a spontaneous miscarriage 4 days ago.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-18
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-22
- 2021-12-23
- 2021-12-27
-
2021-12-30
Survey response — day 28, dose 3MedDRA: Fatigue — Feeling: FairFree text: FatigueMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | No |
| 2 | 2021-02-17 | Moderna | No |
| 3 | 2021-12-02 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-18 | Unsuccessful |
Free text
Release 10 — day 14, dose 3
Symptoms: I had a spontaneous miscarriage 4 days ago.
Release 10 — day 28, dose 3
Symptoms: Fatigue
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 | Abortion spontaneous | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release