3J4-14741-52288
1 vaccination
3 coded responses
15 check-ins
3 free-text entries
7 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 841 / UT
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2020-12-31
Registered in v-safe
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2020-12-31
Dose 1 — Moderna
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2020-12-31
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
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2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-01-01
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)
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2021-01-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-01-02
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)
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2021-01-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-01-03
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2021-01-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-01-04
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2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Scheduled an appointment with primary care doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-05
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-07
Health check-in — day 7, dose 1Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
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2021-01-07
Report sent to call center — day 7, dose 1Be unable to work · Get care from a doctor or other healthcare professionalno matching call case
- 2021-01-15
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2021-01-23
Survey response — day 21, dose 1MedDRA: Feeling abnormal, Memory impairment — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Brain fog. Cant remember lots of thingsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-28
- 2021-02-04
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2021-02-04
Call successfulCompleted over the phone
- 2021-02-06
- 2021-02-11
- 2021-04-01
- 2021-07-01
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2022-01-02
Survey response — 12 months, dose 1MedDRA: Bone pain — Feeling: Fair · 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: lots of bone painMedDRA releases: 2024-11 · check-in free text available
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2022-01-02
Report sent to call center — 12 months, dose 1Be 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)
- 2022-01-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-01 | Successful | Completed over the phone |
| 2021-01-02 | Successful | Completed over the phone |
| 2021-01-03 | Successful | Completed over the phone |
| 2021-01-04 | Successful | Completed over the phone |
| 2021-01-05 | Successful | Completed over the phone |
| 2021-01-23 | Successful 2021-02-04 |
Completed over the phone |
| 2022-01-02 | Unsuccessful |
1 report(s) with no call case — see the timeline.
Free text
Release 1 — days 1–6 daily, dose 1
Healthcare visit (other): Scheduled an appointment with primary care doctor
Release 2 — day 21, dose 1
Symptoms: Brain fog. Cant remember lots of things
Release 10 — 12 months, dose 1
Symptoms: lots of bone pain
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 |
|---|---|---|---|---|
| HCVO | No adverse event | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ○ | ○ | ○ |
| SD | Bone pain | · | · | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release