4VE-57411-42915
2 vaccinations
2 coded responses
26 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 785 / TX
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-08
Registered in v-safe
-
2021-03-08
Dose 1 — Moderna
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-22
- 2021-03-29
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · HeadacheAdult check-in
-
2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Abdominal painAdult check-in
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
-
2021-07-05
Survey response — 3 months, dose 2MedDRA: Fallopian tube adhesion, Fallopian tube disorder, Office visit, Ovarian disorder — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Found out my fallopian tubes are damaged/scared. Now the only way I can conceive is through IVF. Don't think this has anything to do with the vaccination. But did find out after receiving vaccination. · Healthcare visit (other): Doctors visitsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-05
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-08
- 2021-10-06
-
2022-04-05
Survey response — 12 months, dose 2MedDRA: Nerve injury, Office visit, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Going to 2 weeks with ringing in my ears. Doctor said i have some nerve damage but dont know how i got it. · Healthcare visit (other): Regular doctors appointment (in person)MedDRA releases: 2024-11 · check-in free text available
-
2022-04-05
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-06
-
2022-04-14
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-05 | Successful | Participant prefers to complete VAERS report online |
| 2022-04-05 | Successful 2022-04-14 |
Participant prefers to complete VAERS report online |
Free text
Release 9 — 3 months, dose 2
Symptoms: Found out my fallopian tubes are damaged/scared. Now the only way I can conceive is through IVF. Don't think this has anything to do with the vaccination. But did find out after receiving vaccination.
Healthcare visit (other): Doctors visits
Release 11 — 12 months, dose 2
Symptoms: Going to 2 weeks with ringing in my ears. Doctor said i have some nerve damage but dont know how i got it.
Healthcare visit (other): Regular doctors appointment (in person)
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Fallopian tube adhesion | · | · | ✓ |
| SD | Fallopian tube disorder | · | · | ✓ |
| SD | Nerve injury | · | · | ✓ |
| SD | Ovarian disorder | ✓ | ✓ | ○ |
| SD | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release