5AR-11798-13289
3 vaccinations
4 coded responses
39 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 770 / TX
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fever · DiarrheaAdult check-in
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Muscle spasms — Feeling: GoodFree text: Muscle spasm at/around injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-11
Dose 2 — Moderna
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal painFree text: Light isolated abdominal painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Throat irritation — Feeling: GoodFree text: Itchy/scratchy throat - MildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-27
- 2021-05-15
-
2021-08-13
Survey response — 6 months, dose 2MedDRA: Heart rate abnormal — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Changes in heart rate/rhythmMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-13
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-09
-
2022-02-11
Dose 3 — Moderna
- 2022-02-11
- 2022-02-11
-
2022-02-12
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-02-13
- 2022-02-14
- 2022-02-15
- 2022-02-16
- 2022-02-17
- 2022-02-18
- 2022-02-25
- 2022-03-04
- 2022-03-18
- 2022-03-25
- 2022-05-13
- 2022-08-12
- 2023-02-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2022-02-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-13 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Muscle spasm at/around injection site
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Light isolated abdominal pain
Systemic reaction (other): Itchy/scratchy throat - Mild
Release 9 — 6 months, dose 2
Symptoms: Changes in heart rate/rhythm
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 | Heart rate abnormal | ✓ | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release