3KH-93491-63198
3 vaccinations
3 coded responses
16 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 928 / CA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
WHS-25864-68136
Child or adolescent in my care · Male · 2021-12-03
Timeline
-
2021-03-15
Dose 1 — Moderna
-
2021-04-12
Dose 2 — Moderna
-
2021-04-13
Registered in v-safe
-
2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to workAdult check-in
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
-
2021-04-26
Survey response — day 14, dose 2MedDRA: Fatigue, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Legs numbness, tired,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-07-12
- 2021-10-13
-
2022-01-10
Dose 3 — Moderna
-
2022-04-12
Survey response — 12 months, dose 2MedDRA: Cough, Lung opacity — Feeling: FairMedDRA releases: 2024-11
-
2023-01-10
Survey response — 12 months, dose 3MedDRA: Breast cyst, Nodule, Ovarian cyst, Thyroid mass — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-10
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-01-11
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Moderna | |
| 2 | 2021-04-12 | Moderna | |
| 3 | 2022-01-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-01-10 | Successful 2023-01-11 |
Not applicable - Accidental Reporting |
Free text
Release 8 — day 14, dose 2
Symptoms: Legs numbness, tired,
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 | Breast cyst | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Lung opacity | · | · | ✓ |
| SD | Nodule | · | · | ✓ |
| SD | Ovarian cyst | · | · | ✓ |
| SD | Thyroid mass | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release