3KK-19926-57737
4 vaccinations
1 coded response
23 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 946 / CA
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-06
- 2021-01-11
- 2021-01-20
-
2021-01-22
Dose 2 — Moderna
-
2021-01-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-01-26
- 2021-01-27
- 2021-01-31
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-28
- 2021-03-05
- 2021-04-23
-
2021-12-13
Dose 3 — Pfizer-BioNTech
- 2022-01-22
-
2022-06-15
Survey response — 6 months, dose 3MedDRA: Deep vein thrombosis — 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 · Emergency room or emergency department visitFree text: DVTMedDRA releases: 2024-11 · check-in free text available
-
2022-06-15
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
-
2022-06-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-22
Dose 4 — Pfizer-BioNTech
- 2022-10-13
- 2022-10-27
- 2022-11-03
- 2022-12-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-22 | Moderna | |
| 3 | 2021-12-13 | Pfizer-BioNTech | No |
| 4 | 2022-09-22 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-15 | Successful 2022-06-17 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 6 months, dose 3
Symptoms: DVT
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 | Deep vein thrombosis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release