3DW-17131-78497
3 vaccinations
2 coded responses
27 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 787 / TX
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
PBJ-29198-14401
Child or adolescent in my care · Male · 2021-11-13
M22-32730-56788
Child or adolescent in my care · Female · 2021-11-13
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-21
- 2021-01-30
- 2021-02-07
-
2021-02-11
Dose 2 — Moderna
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Dysgeusia, Hyperhidrosis, Paraesthesia oral — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Tingling of tongue and metallic taste in the mouth, chills and then sweating without a feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-14
- 2021-02-17
- 2021-02-20
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-05-13
- 2021-08-12
-
2021-12-06
Dose 3 — Moderna
- 2021-12-11
- 2021-12-12
- 2021-12-15
- 2021-12-29
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-03-07
-
2022-06-07
Survey response — 6 months, dose 3MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tested positive for COVID todayMedDRA releases: 2024-11 · check-in free text available
-
2022-06-07
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-12-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-07 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Tingling of tongue and metallic taste in the mouth, chills and then sweating without a fever
Release 11 — 6 months, dose 3
Symptoms: Tested positive for COVID today
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 | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release