4XP-21166-57015
2 vaccinations
2 coded responses
26 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 935 / CA
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
- 2021-01-04
-
2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · HeadacheFree text: Slight dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-13
- 2021-01-18
- 2021-01-25
-
2021-02-02
Dose 2 — Moderna
- 2021-02-02
-
2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Nausea, DiarrheaAdult check-in
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2022-02-02
Survey response — 12 months, dose 2MedDRA: Cough, Headache, Pain, Respiratory tract congestion, Thrombosis — 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 professional · Telehealth, virtual health, or email health consultationFree text: Body aches, cough, congestion, headache, blood clotMedDRA releases: 2024-11 · check-in free text available
-
2022-02-02
Report sent to call center — 12 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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-03-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-02 | Unsuccessful |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Slight dizziness
Release 11 — 12 months, dose 2
Symptoms: Body aches, cough, congestion, headache, blood clot
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 | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Thrombosis | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release