4UF-29100-88632
2 vaccinations
6 coded responses
23 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 317 / GA
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
-
2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Middle insomnia, Night sweats — Feeling: GoodFree text: All though I am feeling fine, I woke up soaked in sweat last night. This is not at all normal for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-16
-
2021-03-23
Survey response — day 21, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Dizziness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-30
Dose 2 — Moderna
- 2021-03-30
-
2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, NauseaFree text: The injection site is warmer than the rest of my arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: Slight dull headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-03
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-05
-
2021-04-06
Survey response — day 7, dose 2MedDRA: COVID-19, Quarantine — Feeling: Good · Headache · Be unable to workFree text: I am currently Covid Positive and am quarantined. I had to have a Covid test due to an upcoming medical procedure and it popped positiveMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Survey response — day 14, dose 2MedDRA: Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I found that the shot flared my Inflammatory Bowel Disease and I had to get antibiotics to control the flare up. · Healthcare visit (other): Colonoscopy to find what was wrong.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-20
- 2021-04-27
- 2021-05-11
- 2021-06-29
-
2022-03-30
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): All though I am feeling fine, I woke up soaked in sweat last night. This is not at all normal for me.
Release 6 — day 21, dose 1
Symptoms: Dizziness.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): The injection site is warmer than the rest of my arm.
Systemic reaction (other): Slight dull headache.
Release 7 — day 7, dose 2
Systemic reaction (other): I am currently Covid Positive and am quarantined. I had to have a Covid test due to an upcoming medical procedure and it popped positive
Release 7 — day 14, dose 2
Symptoms: I found that the shot flared my Inflammatory Bowel Disease and I had to get antibiotics to control the flare up.
Healthcare visit (other): Colonoscopy to find what was wrong.
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 | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | COVID-19 | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Quarantine | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release