3J2-89174-78361
1 vaccination
1 coded response
7 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 787 / TX
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
-
2021-01-26
Dose 1 — Moderna
- 2021-01-26
-
2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-27
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-02
-
2022-01-26
Survey response — 12 months, dose 1MedDRA: COVID-19, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: When I tested positive for COVID at home at the date below, I experienced symptoms for about 20 days (even after testing negative on day 10)MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-27 | priority 2/3 |
Free text
Release 11 — 12 months, dose 1
Symptoms: When I tested positive for COVID at home at the date below, I experienced symptoms for about 20 days (even after testing negative on day 10)
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 | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release