4DH-36283-64615
3 vaccinations
1 coded response
40 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 598 / MT
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
VBU-14459-92929
Child or adolescent in my care · Male · 2021-11-30
8SA-26960-26495
Child or adolescent in my care · Female · 2021-11-30
Timeline
-
2021-03-24
Registered in v-safe
-
2021-03-24
Dose 1 — Moderna
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-07
- 2021-04-14
-
2021-04-21
Dose 2 — Moderna
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-07-21
-
2021-10-20
Survey response — 6 months, dose 2MedDRA: Abortion missed, Abortion spontaneous, Anembryonic gestation, Medical counselling, Pregnancy test positive — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I had a missed miscarriage (blighted ovum). Positive pregnancy test in early June, miscarriage beginning July 31. · Healthcare visit (other): Certified Nurse midwifeMedDRA releases: 2024-11 · check-in free text available
-
2021-10-20
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-22
-
2021-11-30
Dose 3 — Moderna
-
2021-12-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-02
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-03-01
- 2022-05-31
- 2022-11-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-24 | Moderna | |
| 2 | 2021-04-21 | Moderna | |
| 3 | 2021-11-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-20 | Unsuccessful |
Free text
Release 10 — 6 months, dose 2
Symptoms: I had a missed miscarriage (blighted ovum). Positive pregnancy test in early June, miscarriage beginning July 31.
Healthcare visit (other): Certified Nurse midwife
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 | Medical counselling | · | · | ✓ |
| SD | Abortion missed | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Anembryonic gestation | · | · | ✓ |
| SD | Pregnancy test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release