4NA-10441-58127
4 vaccinations
1 coded response
37 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 070 / NJ
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-28
Dose 1 — Moderna
-
2021-03-01
Registered in v-safe
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-07
- 2021-03-16
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-05-02
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-11-01
Dose 3 — ModernaCo-administered: Do not remember:Flu
- 2022-04-02
-
2022-10-28
Dose 4 — ModernaCo-administered: Tetanus
-
2022-10-28
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2022-10-29
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-30
- 2022-10-31
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-11
-
2022-11-18
Survey response — day 21, dose 4MedDRA: Headache, Oropharyngeal pain, Pain, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throat, headache, body aches, sneezingMedDRA releases: 2024-11 · check-in free text available
-
2022-11-18
Report sent to call center — day 21, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-21
-
2022-11-21
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-25
- 2022-12-04
- 2022-12-09
- 2023-01-27
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-28 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-11-01 | Moderna | Do not remember:Flu |
| 4 | 2022-10-28 | Moderna | Tetanus |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-18 | Successful 2022-11-21 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — day 21, dose 4
Symptoms: Sore throat, headache, body aches, sneezing
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 | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release