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443-10230-72584

4 vaccinations 4 coded responses 21 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
41-45
ZIP prefix
017 / MA
Registered
2021-05-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
UM4-14688-31560 Child or adolescent in my care · Male · 2021-11-09

Timeline

  1. 2021-04-10
    Dose 1 — Moderna
  2. 2021-05-09
    Registered in v-safe
  3. 2021-05-09
    Dose 2 — Moderna
  4. 2021-05-09
    Survey response — day 0, dose 2
    MedDRA: Anxiety — Feeling: Fair
    Free text: Intense short bursts of anxiety
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-05-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-05-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-05-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-05-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-05-16
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-05-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-06-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-06-06
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  14. 2021-06-13
    Survey response — day 35, dose 2
    MedDRA: Anxiety — Feeling: Fair
    Free text: General anxiety
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-20
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-08-08
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-11-07
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-12-18
    Dose 3 — Moderna
    Co-administered: Flu
  19. 2022-06-20
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  20. 2022-11-09
    Dose 4 — Moderna
  21. 2022-11-30
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  22. 2022-12-07
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  23. 2022-12-18
    Survey response — day 35, dose 4
    MedDRA: Chest discomfort, Paranasal sinus discomfort — Feeling: Fair
    Free text: Sinus pressure and tightness in lungs.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2022-12-26
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  25. 2023-02-08
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  26. 2023-05-11
    Survey response — 6 months, dose 4
    MedDRA: Dizziness, Insomnia, Menopause, Weight increased — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  27. 2023-05-11
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  28. 2023-05-12
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-04-10Moderna
22021-05-09Moderna
32021-12-18Moderna Flu
42022-11-09Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2023-05-11 Successful
2023-05-12
Does not wish to fill out VAERS report

Free text

Release 8 — day 0, dose 2

2021-05-09

Systemic reaction (other): Intense short bursts of anxiety

Release 9 — day 35, dose 2

2021-06-13

Symptoms: General anxiety

Release 12 — day 35, dose 4

2022-12-18

Symptoms: Sinus pressure and tightness in lungs.

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

FieldPreferred term2021-092023-042024-11
SDAnxiety ✓ ✓ ✓
SDChest discomfort · · ✓
SDDizziness · · ✓
SDInsomnia · · ✓
SDMenopause · · ✓
SDParanasal sinus discomfort · · ✓
SDWeight increased · · ✓
SROAnxiety ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release