4QB-23809-89802
3 vaccinations
1 coded response
38 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 210 / MD
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
PKS-17045-44772
Child or adolescent in my care · Female · 2022-06-23
Timeline
-
2021-04-16
Registered in v-safe
-
2021-04-16
Dose 1 — Moderna
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-04-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
-
2021-04-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-21
-
2021-04-22
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
- 2021-04-23
- 2021-04-30
- 2021-05-07
-
2021-05-14
Dose 2 — Moderna
-
2021-05-14
Health check-in — day 0, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-05-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-05-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to workAdult check-in
- 2021-05-19
- 2021-05-20
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-06-13
- 2021-06-18
- 2021-06-25
- 2021-08-13
- 2021-11-12
-
2022-01-05
Dose 3 — Pfizer-BioNTech
- 2022-01-05
-
2022-01-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2022-01-08
- 2022-01-10
- 2022-01-11
- 2022-01-12
- 2022-01-19
-
2022-01-26
Survey response — day 21, dose 3MedDRA: Chills, Cough, Pyrexia, Rhinorrhoea, Unevaluable event, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Fever, chills, vomiting, runny nose, dry cough · Healthcare visit (other): NoneMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — day 21, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2022-01-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-02
- 2022-02-09
- 2022-02-16
- 2022-04-06
- 2022-07-06
- 2023-01-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Moderna | |
| 2 | 2021-05-14 | Moderna | |
| 3 | 2022-01-05 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-26 | Successful 2022-01-29 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 11 — day 21, dose 3
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 | Unevaluable event | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release