4JV-23222-67909
1 vaccination
1 coded response
6 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 936 / CA
- Registered
- 2021-08-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-13
Dose 1 — Moderna
-
2021-08-14
Registered in v-safe
-
2021-08-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
-
2021-08-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-08-16
- 2021-08-17
- 2021-08-20
-
2021-08-29
Survey response — day 14, dose 1MedDRA: COVID-19, Cough, Headache, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Covid positive. Headaches cough congestionMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-29
Report sent to call center — day 14, dose 1Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-31
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-29 | Successful 2021-08-31 |
Participant prefers to complete VAERS report online |
Free text
Release 9 — day 14, dose 1
Symptoms: Covid positive. Headaches cough congestion
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 | Cough | ✓ | · | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release