3EC-39577-81126
3 vaccinations
6 coded responses
40 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 100 / NY
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KXV-66618-33164
Child or adolescent in my care · Female · 2021-06-25
3C2-20599-32524
Child or adolescent in my care · Male · 2021-06-25
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Headache leaning to the left side of head that happened to be on the left arm site of injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Dry throat, Fatigue — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Felt mildly fatigue last night but resolved today. Residual dry throat in the morning, but appeared to have been resolved in the afternoon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-13
- 2021-02-19
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
-
2021-03-06
Survey response — day 14, dose 2MedDRA: Asthenia, Chills — Feeling: GoodFree text: Felt slight weakness and slight chilled for most of this week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — day 21, dose 2MedDRA: Pyrexia — Feeling: GoodFree text: Felt mild feverish temperature for 2-3 day out of the week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-05-22
- 2021-08-21
-
2021-11-12
Dose 3 — Moderna
- 2021-11-13
- 2021-11-14
-
2021-11-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2022-02-11
-
2022-05-13
Survey response — 6 months, dose 3MedDRA: Sjogren's syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Has been diagnosed with Sjogrens and requiring treatment.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-13
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-17
-
2022-11-12
Survey response — 12 months, dose 3MedDRA: Sjogren's syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Had 3 dowse of Moderna. Then in 3/2022 diagnosed with Sjogren's in 3/2022.MedDRA releases: 2024-11 · check-in free text available
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2022-11-12
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-14
- 2022-11-14
-
2022-11-14
Call successfulParticipant prefers to complete VAERS report online
-
2022-11-14
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Headache leaning to the left side of head that happened to be on the left arm site of injection.
Systemic reaction (other): Felt mildly fatigue last night but resolved today. Residual dry throat in the morning, but appeared to have been resolved in the afternoon.
Release 5 — day 14, dose 2
Symptoms: Felt slight weakness and slight chilled for most of this week.
Release 5 — day 21, dose 2
Symptoms: Felt mild feverish temperature for 2-3 day out of the week.
Release 11 — 6 months, dose 3
Symptoms: Has been diagnosed with Sjogrens and requiring treatment.
Release 12 — 12 months, dose 3
Symptoms: Had 3 dowse of Moderna. Then in 3/2022 diagnosed with Sjogren's in 3/2022.
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 | Asthenia | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Sjogren's syndrome | · | · | ✓ |
| SRO | Dry throat | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release