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
-
2021-04-10
Dose 1 — Moderna
-
2021-05-09
Registered in v-safe
-
2021-05-09
Dose 2 — Moderna
-
2021-05-09
Survey response — day 0, dose 2MedDRA: Anxiety — Feeling: FairFree text: Intense short bursts of anxietyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-23
- 2021-06-01
- 2021-06-06
-
2021-06-13
Survey response — day 35, dose 2MedDRA: Anxiety — Feeling: FairFree text: General anxietyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-20
- 2021-08-08
- 2021-11-07
-
2021-12-18
Dose 3 — ModernaCo-administered: Flu
- 2022-06-20
-
2022-11-09
Dose 4 — Moderna
- 2022-11-30
- 2022-12-07
-
2022-12-18
Survey response — day 35, dose 4MedDRA: Chest discomfort, Paranasal sinus discomfort — Feeling: FairFree text: Sinus pressure and tightness in lungs.MedDRA releases: 2024-11 · check-in free text available
- 2022-12-26
- 2023-02-08
-
2023-05-11
Survey response — 6 months, dose 4MedDRA: 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 visitMedDRA releases: 2024-11
-
2023-05-11
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-05-12
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Moderna | |
| 2 | 2021-05-09 | Moderna | |
| 3 | 2021-12-18 | Moderna | Flu |
| 4 | 2022-11-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-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
Systemic reaction (other): Intense short bursts of anxiety
Release 9 — day 35, dose 2
Symptoms: General anxiety
Release 12 — day 35, dose 4
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Anxiety | ✓ | ✓ | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Menopause | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Weight increased | · | · | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release