3GL-16182-27836
4 vaccinations
3 coded responses
14 check-ins
1 free-text entry
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 070 / NJ
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- Asian
- Ethnicity
- N/A
Timeline
-
2021-02-27
Dose 1 — Moderna
-
2021-03-27
Dose 2 — Moderna
-
2021-03-28
Registered in v-safe
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-28
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities1 call case(s)
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
-
2021-04-05
Health check-in — day 7, dose 2Feeling: Fair · Muscle or body aches, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-12
-
2021-05-01
Survey response — day 35, dose 2MedDRA: Headache — Feeling: FairFree text: HeadachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-09
- 2021-06-26
- 2021-09-25
-
2022-01-07
Dose 3 — Moderna
- 2022-03-27
-
2022-12-29
Dose 4 — Moderna
-
2023-01-07
Health check-in — day 7, dose 4Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2023-01-07
Survey response — 12 months, dose 3MedDRA: COVID-19, Pain — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-01-07
Report sent to call center — day 7, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-09
-
2023-01-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-01-19
Survey response — day 21, dose 4MedDRA: Myalgia, Piriformis syndrome — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-19
Report sent to call center — day 21, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-20
- 2023-02-02
- 2023-02-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Moderna | |
| 2 | 2021-03-27 | Moderna | |
| 3 | 2022-01-07 | Moderna | No |
| 4 | 2022-12-29 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-28 | priority 2/3 | |
| 2023-01-07 | Successful 2023-01-10 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-01-19 | Unsuccessful |
Free text
Release 8 — day 35, dose 2
Symptoms: Headaches
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 | Headache | ✓ | ✓ | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Piriformis syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release