3D3-56421-21753
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 021 / MA
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Dose 1 — Moderna
-
2021-01-06
Registered in v-safe
-
2021-01-06
Survey response — day 7, dose 1MedDRA: Lymphadenopathy — Feeling: Fair · Site: RednessFree text: LymphadenopathyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
-
2021-01-25
Health check-in — day 0, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-10
- 2021-02-15
- 2021-02-24
- 2021-03-03
- 2021-03-08
- 2021-04-26
- 2021-07-26
-
2022-01-27
Survey response — 12 months, dose 2MedDRA: Headache, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — 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: Sore throat, runny nose, headache, congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-01-27
Report sent to call center — 12 months, dose 2Be 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)
-
2022-01-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-27 | Successful 2022-01-31 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): Lymphadenopathy
Release 11 — 12 months, dose 2
Symptoms: Sore throat, runny nose, headache, congestion
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 | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release