3CL-68512-07812
2 vaccinations
3 coded responses
14 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 980 / WA
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Registered in v-safe
-
2021-03-06
Dose 1 — Moderna
-
2021-04-03
Dose 2 — Moderna
- 2021-04-03
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-05
- 2021-04-06
-
2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
- 2021-04-12
- 2021-04-18
- 2021-04-24
-
2021-05-01
Survey response — day 28, dose 2MedDRA: Joint stiffness, Pain in jaw — Feeling: GoodFree text: One sided jaw pain and stiffnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
- 2021-05-15
- 2021-10-04
-
2022-04-03
Survey response — 12 months, dose 2MedDRA: Palpitations, Ventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Heart palpitations and PVCsMedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Report sent to call center — 12 months, dose 2Get 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)
-
2022-04-05
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Moderna | |
| 2 | 2021-04-03 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-03 | Successful 2022-04-05 |
Participant prefers to complete VAERS report online |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Sore throat
Release 8 — day 28, dose 2
Symptoms: One sided jaw pain and stiffness
Release 11 — 12 months, dose 2
Symptoms: Heart palpitations and PVCs
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 | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release