3AW-71600-80319
3 vaccinations
2 coded responses
14 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 815 / CO
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Severe light headednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
- 2021-02-09
- 2021-02-10
- 2021-02-13
- 2021-02-18
- 2021-03-04
- 2021-03-13
- 2021-03-20
- 2021-05-07
-
2021-08-05
Survey response — 6 months, dose 2MedDRA: Antinuclear antibody positive, Fatigue, Habitual abortion — 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: Several Positive ANA tests. Possible autoimmune disease. Miscarriages, fatigueMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-05
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-09
-
2021-08-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-12-20
Dose 3 — Moderna
- 2022-02-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-12-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-05 | Successful 2021-08-17 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Severe light headedness
Release 9 — 6 months, dose 2
Symptoms: Several Positive ANA tests. Possible autoimmune disease. Miscarriages, 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 | Antinuclear antibody positive | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Habitual abortion | ✓ | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release