3PA-26200-09182
2 vaccinations
2 coded responses
3 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 857 / AZ
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-02-12
Dose 2 — Moderna
-
2021-04-15
Registered in v-safe
-
2021-05-14
Survey response — 3 months, dose 2MedDRA: Abortion spontaneous, Hospitalisation, Thrombosis — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Had a miscarriage and was hospitalized. Developed a blood clot in my arm and was hospitalized.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-14
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-14
- 2022-01-20
- 2022-01-25
-
2022-02-14
Survey response — 12 months, dose 2MedDRA: Anxiety — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Anxiety due to husband passing away.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-14
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-02-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-14 | Unsuccessful | |
| 2022-02-14 | Unsuccessful |
Free text
Release 8 — 3 months, dose 2
Symptoms: Had a miscarriage and was hospitalized. Developed a blood clot in my arm and was hospitalized.
Release 11 — 12 months, dose 2
Symptoms: Anxiety due to husband passing away.
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Thrombosis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release