4ZJ-33627-49518
2 vaccinations
4 coded responses
20 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 301 / GA
- Registered
- 2021-08-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-12
Dose 1 — Moderna
-
2021-08-18
Registered in v-safe
-
2021-08-18
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to work or attend schoolFree text: Sore throat and runny noseMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-19
Health check-in — day 7, dose 1Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-08-28
- 2021-09-02
- 2021-09-09
-
2021-09-10
Dose 2 — Moderna
-
2021-09-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-09-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · HeadacheAdult check-in
-
2021-09-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
-
2021-09-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-09-17
- 2021-09-24
- 2021-10-01
- 2021-10-08
-
2021-10-15
Survey response — day 35, dose 2MedDRA: Abdominal pain upper, Diarrhoea, Headache — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Had stomach cramps, diarrhea, headacheMedDRA releases: 2024-11 · check-in free text available
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2021-10-15
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-20
Call successfulDoes not wish to fill out VAERS report
- 2021-10-22
-
2021-12-10
Survey response — 3 months, dose 2MedDRA: Upper respiratory tract infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Upper respiratory infectionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Report sent to call center — 3 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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-13
- 2022-03-11
-
2022-09-12
Survey response — 12 months, dose 2MedDRA: Haemorrhagic disorder, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Abnormal bleeding. · Healthcare visit (other): Went to my OBGYNMedDRA releases: 2024-11 · check-in free text available
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2022-09-12
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-09-13
- 2022-09-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-12 | Moderna | No |
| 2 | 2021-09-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-15 | Successful 2021-10-20 |
Does not wish to fill out VAERS report |
| 2021-12-10 | Unsuccessful | |
| 2022-09-12 | Unsuccessful |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Sore throat and runny nose
Release 10 — day 35, dose 2
Symptoms: Had stomach cramps, diarrhea, headache
Release 10 — 3 months, dose 2
Symptoms: Upper respiratory infection
Release 12 — 12 months, dose 2
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 | Abdominal pain upper | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Haemorrhagic disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | · | ✓ |
| SRO | Rhinorrhoea | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release