4CA-81034-15634
2 vaccinations
2 coded responses
19 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 932 / CA
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
- 2021-01-11
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
-
2021-01-18
Survey response — day 7, dose 1MedDRA: Axillary pain — Feeling: GoodFree text: Pain in armpit, mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-02-01
- 2021-02-10
-
2021-02-11
Dose 2 — Moderna
-
2021-02-22
Health check-in — day 7, dose 2Feeling: Good · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-25
- 2021-03-06
- 2021-03-11
- 2021-03-21
- 2021-03-25
- 2021-05-13
-
2021-08-14
Survey response — 6 months, dose 2MedDRA: Folate deficiency — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Folic acid deficiency. Likely unrelated to vaccination.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-14
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-18
- 2022-02-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-11 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-14 | Unsuccessful |
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Pain in armpit, mild
Release 9 — 6 months, dose 2
Symptoms: Folic acid deficiency. Likely unrelated to vaccination.
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 | Folate deficiency | ✓ | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release