3HJ-11140-97881
2 vaccinations
3 coded responses
7 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 815 / CO
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Dose 1 — Moderna
-
2021-02-09
Registered in v-safe
-
2021-02-09
Dose 2 — Moderna
-
2021-02-09
Survey response — day 0, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Cold sweat, Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Cold sweats, dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-13
- 2021-02-23
- 2021-08-10
-
2022-02-11
Survey response — 12 months, dose 2MedDRA: Chills, Cough, Dyspnoea, Fatigue, Pyrexia, Sinus congestion — Feeling: Good · 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: 3 week illness with bad cough, fever, chills, SOB, sinus congestion, fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-02-11
Report sent to call center — 12 months, dose 2Be 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)
-
2022-02-16
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-11 | Successful 2022-02-16 |
Participant prefers to complete VAERS report online |
Free text
Release 3 — day 0, dose 2
Systemic reaction (other): Dizziness
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Cold sweats, dizziness
Release 11 — 12 months, dose 2
Symptoms: 3 week illness with bad cough, fever, chills, SOB, sinus congestion, fatigue.
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Cold sweat | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release