4QG-39623-05917
3 vaccinations
5 coded responses
17 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 349 / FL
- Registered
- 2021-05-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-08
Dose 1 — Moderna
-
2021-05-10
Registered in v-safe
-
2021-05-10
Dose 2 — Moderna
- 2021-05-10
-
2021-05-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-12
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessFree text: Light headed in morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-13
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-06-21
-
2021-08-09
Survey response — 3 months, dose 2MedDRA: Nasopharyngitis — Feeling: Good · 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: I had a cold about a month agoMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-09
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-11-10
Survey response — 6 months, dose 2MedDRA: Abdominal mass, Diastasis recti abdominis, Hernia repair, Mass excision — 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 · HospitalizationFree text: Hernia repair, abdominal mass excision and abdominal diastsisMedDRA releases: 2024-11 · check-in free text available
-
2021-11-10
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2021-11-12
-
2021-12-21
Dose 3 — Pfizer-BioNTech
-
2022-06-21
Survey response — 6 months, dose 3MedDRA: COVID-19, Cough, Headache, Rhinorrhoea, Sinusitis, Sneezing — Feeling: Good · 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: Covid - Felt like I had a bad sinus infection. Runny nose, sneezing, slight cough. Headache for a few hours. Symptoms lasted two days.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-21
Report sent to call center — 6 months, dose 3Be 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)
-
2022-06-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-06-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-06-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-23
Survey response — 12 months, dose 3MedDRA: Pregnancy — Feeling: GoodFree text: I'm pregnantMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna | |
| 2 | 2021-05-10 | Moderna | |
| 3 | 2021-12-21 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-09 | Successful 2022-06-22 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-11-10 | Successful 2022-06-22 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-06-21 | Successful 2022-06-22 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Light headed in morning
Release 9 — 3 months, dose 2
Symptoms: I had a cold about a month ago
Release 10 — 6 months, dose 2
Symptoms: Hernia repair, abdominal mass excision and abdominal diastsis
Release 12 — 6 months, dose 3
Symptoms: Covid - Felt like I had a bad sinus infection. Runny nose, sneezing, slight cough. Headache for a few hours. Symptoms lasted two days.
Release 12 — 12 months, dose 3
Symptoms: I'm pregnant
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 | Abdominal mass | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diastasis recti abdominis | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hernia repair | · | · | ✓ |
| SD | Mass excision | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release