4YV-94794-55015
1 vaccination
3 coded responses
12 check-ins
3 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 294 / SC
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
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2021-03-17
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Good · Site: PainFree text: Light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: Rectal haemorrhage — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Rectal bleedingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
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2021-03-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Muscle or body achesAdult check-in
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2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Office visit — Feeling: Good · Joint pains, Muscle or body aches, Nausea · Get care from a doctor or other healthcare professionalFree text: Doctor visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-22
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-23
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-03-23
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-03-24
Health check-in — day 7, dose 1Feeling: Good · Headache, Joint pains, Muscle or body aches, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
-
2021-03-24
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-31
- 2021-04-07
- 2021-04-10
- 2021-06-18
- 2021-09-15
- 2022-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-18 | Unsuccessful | |
| 2021-03-22 | Unsuccessful | |
| 2021-03-23 | priority 2/3 | |
| 2021-03-24 | Unsuccessful |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Light headed
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Rectal bleeding
Release 6 — days 1–6 daily, dose 1
Healthcare visit (other): Doctor visit
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 | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Rectal haemorrhage | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release