56T-16907-04663
2 vaccinations
3 coded responses
14 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 260 / WV
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-22
Registered in v-safe
-
2020-12-22
Dose 1 — Moderna
- 2020-12-22
-
2020-12-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2020-12-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2020-12-25
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2020-12-26
- 2020-12-27
-
2020-12-30
Health check-in — day 7, dose 1Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
-
2021-01-18
Dose 2 — Moderna
-
2021-01-19
Survey response — days 1–6 daily, dose 2MedDRA: Hot flush — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Hot flashesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-20
Survey response — days 1–6 daily, dose 2MedDRA: Exhibitionism, Hot flush — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workFree text: Hot flashesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessAdult check-in
- 2021-01-23
- 2021-01-24
-
2021-07-21
Survey response — 6 months, dose 2MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Rash on armMedDRA releases: 2024-11 · check-in free text available
-
2021-07-21
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
- 2022-01-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Moderna | |
| 2 | 2021-01-18 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2020-12-25 | priority 2/3 | |
| 2021-07-21 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Hot flashes
Systemic reaction (other): Hot flashes
Release 9 — 6 months, dose 2
Symptoms: Rash on arm
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 | Rash | · | · | ✓ |
| SRO | Exhibitionism | ○ | ✓ | ○ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release