3KF-40826-96711
4 vaccinations
3 coded responses
14 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 951 / CA
- Registered
- 2021-04-19
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
XEK-65542-20937
Child or adolescent in my care · Female · 2022-07-16
Timeline
-
2021-04-19
Registered in v-safe
-
2021-04-19
Dose 1 — Moderna
- 2021-04-19
-
2021-04-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-21
- 2021-04-22
- 2021-04-23
-
2021-05-17
Dose 2 — Moderna
- 2021-05-17
-
2021-05-18
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-06-28
- 2021-08-18
-
2021-11-17
Survey response — 6 months, dose 2MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: GoodFree text: Running nose, sore throatMedDRA releases: 2024-11 · check-in free text available
-
2021-11-21
Dose 3 — Moderna
- 2022-05-22
-
2022-06-03
Dose 4 — Moderna
-
2022-07-16
Survey response — day 42, dose 4MedDRA: Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Cold symptomsMedDRA releases: 2024-11 · check-in free text available
- 2022-12-04
-
2023-06-05
Survey response — 12 months, dose 4MedDRA: Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
- 2023-06-05
- 2023-06-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-19 | Moderna | |
| 2 | 2021-05-17 | Moderna | |
| 3 | 2021-11-21 | Moderna | No |
| 4 | 2022-06-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-06-05 | Unsuccessful |
Free text
Release 10 — 6 months, dose 2
Symptoms: Running nose, sore throat
Release 12 — day 42, dose 4
Symptoms: Cold symptoms
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 | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release