37J-14167-89541
3 vaccinations
1 coded response
4 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 104 / NY
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KBC-23485-51898
Child or adolescent in my care · Female · 2021-10-26
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-02-14
Registered in v-safe
-
2021-02-14
Dose 2 — Moderna
- 2021-02-14
- 2021-02-23
-
2021-10-25
Dose 3 — Moderna
- 2021-10-29
-
2022-04-25
Survey response — 6 months, dose 3MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, 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: Had CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-04-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-14 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-25 | Unsuccessful |
Free text
Release 11 — 6 months, dose 3
Symptoms: Had Covid
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 | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release