3X9-55211-86114
3 vaccinations
4 coded responses
36 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 105 / NY
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Moderna
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
-
2021-04-14
Survey response — day 14, dose 1MedDRA: Axillary pain, Lymphadenopathy — Feeling: GoodFree text: Very minor but I did notice a funny twinge feeling near my left armpit and wondered (per nurse instruction post vaccine) whether it had anything to do with swollen lymph nodes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
-
2021-04-28
Dose 2 — Moderna
- 2021-04-28
-
2021-04-29
Survey response — days 1–6 daily, dose 2MedDRA: Insomnia — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Difficulty sleepingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-30
- 2021-05-01
- 2021-05-02
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
-
2021-07-28
Survey response — 3 months, dose 2MedDRA: Pregnancy — Feeling: GoodFree text: Im now pregnantMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-27
Survey response — 6 months, dose 2MedDRA: Abortion missed, Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Symptoms: I had a missed miscarriage at 11 weeks · Healthcare visit (other): Outpatient hospital procedureMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2021-10-28
-
2021-12-08
Dose 3 — Moderna
- 2021-12-09
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-01-05
- 2022-01-12
- 2022-01-19
- 2022-03-09
- 2022-06-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-12-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-27 | Unsuccessful |
Free text
Release 7 — day 14, dose 1
Symptoms: Very minor but I did notice a funny twinge feeling near my left armpit and wondered (per nurse instruction post vaccine) whether it had anything to do with swollen lymph nodes.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Difficulty sleeping
Release 9 — 3 months, dose 2
Symptoms: Im now pregnant
Release 10 — 6 months, dose 2
Symptoms: I had a missed miscarriage at 11 weeks
Healthcare visit (other): Outpatient hospital procedure
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 |
|---|---|---|---|---|
| HCVO | Surgery | · | · | ✓ |
| SD | Abortion missed | · | · | ✓ |
| SD | Axillary pain | ✓ | · | ✓ |
| SD | Lymphadenopathy | ○ | ✓ | ○ |
| SD | Pregnancy | ✓ | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release