3EA-17368-42366
3 vaccinations
4 coded responses
29 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 223 / VA
- Registered
- 2021-04-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Dose 1 — Moderna
-
2021-04-22
Registered in v-safe
-
2021-04-22
Dose 2 — Moderna
- 2021-04-22
-
2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: Dehydration — Feeling: Good · Site: Pain · HeadacheFree text: DehydrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body achesFree text: CongestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion — Feeling: Fair · HeadacheFree text: CongestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-27
- 2021-04-28
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-07-22
- 2021-10-21
-
2021-12-08
Dose 3 — Moderna
- 2021-12-10
-
2021-12-11
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Muscle or body aches, DiarrheaAdult check-in
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-01-05
-
2022-01-12
Survey response — day 35, dose 3MedDRA: COVID-19, Respiratory tract congestion — Feeling: Poor · 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: Congestion, COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-01-12
Report sent to call center — day 35, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-19
- 2022-03-09
- 2022-06-08
- 2022-12-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2021-12-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-12 | Successful 2022-01-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Dehydration
Systemic reaction (other): Congestion
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Congestion
Release 10 — day 35, dose 3
Symptoms: Congestion, 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 | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Dehydration | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release