424-67810-00802
4 vaccinations
4 coded responses
50 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 347 / FL
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
SJU-24769-86466
Child or adolescent in my care · Male · 2022-07-25
Timeline
-
2021-03-09
Registered in v-safe
-
2021-03-09
Dose 1 — Moderna
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-23
- 2021-03-30
-
2021-04-06
Dose 2 — Moderna
-
2021-04-06
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-21
- 2021-04-27
-
2021-05-04
Survey response — day 28, dose 2MedDRA: Headache, Irritable bowel syndrome, Pre-existing disease — Feeling: FairFree text: Headaches and increase in IBS symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-11
Survey response — day 35, dose 2MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Worsening ibs symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-18
- 2021-07-06
- 2021-10-05
-
2021-12-07
Dose 3 — Moderna
- 2021-12-09
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-01-18
-
2022-03-08
Survey response — 3 months, dose 3MedDRA: Nasal congestion, Nasopharyngitis, Productive cough, SARS-CoV-2 test negative, Sneezing — Feeling: GoodFree text: Cold symptoms. Sneezing, stuffy nose, cough with phlegm. Negative at home COVID test.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-07
-
2022-07-23
Dose 4 — Pfizer-BioNTech
-
2022-07-25
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-07-26
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2022-07-27
- 2022-07-28
- 2022-07-29
- 2022-08-01
- 2022-08-06
- 2022-08-13
- 2022-08-20
- 2022-08-27
- 2022-09-03
-
2023-01-21
Survey response — 6 months, dose 4MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-21
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-06 | Moderna | |
| 3 | 2021-12-07 | Moderna | No |
| 4 | 2022-07-23 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-01-21 | Unsuccessful |
Free text
Release 8 — day 28, dose 2
Symptoms: Headaches and increase in IBS symptoms.
Release 8 — day 35, dose 2
Symptoms: Worsening ibs symptoms
Release 11 — 3 months, dose 3
Symptoms: Cold symptoms. Sneezing, stuffy nose, cough with phlegm. Negative at home COVID test.
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 | Headache | ✓ | ✓ | ✓ |
| SD | Irritable bowel syndrome | ✓ | ✓ | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release