3J5-71237-81507
2 vaccinations
1 coded response
11 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 100 / NY
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-18
Dose 1 — Moderna
-
2021-03-06
Registered in v-safe
- 2021-03-06
- 2021-03-11
-
2021-03-18
Dose 2 — Moderna
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-06-17
Survey response — 3 months, dose 2MedDRA: Food poisoning, Large intestine infection — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Infectious colitis from food poisoningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-17
Report sent to call center — 3 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 pr1 call case(s)
- 2021-06-24
- 2021-06-25
- 2021-06-29
-
2021-06-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-09-17
- 2022-03-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-18 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-17 | Successful 2021-06-29 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 9 — 3 months, dose 2
Symptoms: Infectious colitis from food poisoning
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 | Food poisoning | ✓ | ✓ | ✓ |
| SD | Large intestine infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release