4XF-10854-83125
5 vaccinations
2 coded responses
30 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 404 / KY
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Dose 1 — Moderna
-
2021-03-03
Dose 2 — Moderna
-
2021-03-06
Registered in v-safe
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-12
- 2021-03-17
- 2021-03-24
- 2021-04-02
- 2021-04-07
- 2021-04-14
- 2021-09-03
-
2021-11-11
Dose 3 — Moderna
- 2022-03-03
-
2022-04-15
Dose 4 — Moderna
- 2022-04-29
- 2022-05-06
-
2022-05-17
Survey response — day 28, dose 4MedDRA: Cough, Respiratory tract congestion, Sneezing — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: congestion, cough, sneezingMedDRA releases: 2024-11 · check-in free text available
-
2022-05-17
Report sent to call center — day 28, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-18
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-20
- 2022-05-27
-
2022-07-15
Survey response — 3 months, dose 4MedDRA: Cholelithiasis, Office visit — 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: Gallstones · Healthcare visit (other): Primary care provider office visit, diagnostic centerMedDRA releases: 2024-11 · check-in free text available
-
2022-07-15
Report sent to call center — 3 months, dose 4Be 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)
- 2022-07-19
-
2022-10-12
Dose 5 — Moderna
-
2022-10-13
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2022-10-15
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-26
- 2022-11-04
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2023-01-11
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-10-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-17 | Successful 2022-05-18 |
Participant prefers to complete VAERS report online |
| 2022-07-15 | Unsuccessful |
Free text
Release 11 — day 28, dose 4
Symptoms: congestion, cough, sneezing
Release 12 — 3 months, dose 4
Symptoms: Gallstones
Healthcare visit (other): Primary care provider office visit, diagnostic center
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 | Cholelithiasis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release