3FV-17689-83603
2 vaccinations
1 coded response
17 check-ins
1 free-text entry
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 100 / NY
- Registered
- 2021-02-28
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-24
Dose 1 — Moderna
-
2021-02-28
Registered in v-safe
- 2021-02-28
- 2021-03-02
- 2021-03-10
- 2021-03-17
- 2021-03-24
-
2021-03-27
Dose 2 — Moderna
-
2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Syncope — Feeling: Fair · Site: Pain, Swelling · Chills, Headache · Be unable to do your normal daily activitiesFree text: Fainting 3/28/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
- 2021-04-02
- 2021-04-05
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-06-27
- 2021-09-25
- 2022-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-27 | Moderna |
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Fainting 3/28/21
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 |
|---|---|---|---|---|
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release