5DD-28546-25024
2 vaccinations
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 200 / DC
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-04-13
Registered in v-safe
- 2021-04-13
-
2021-04-15
Dose 2 — Moderna
-
2021-04-15
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Dehydration, Dry mouth — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: dehydrated- dry mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-19
- 2021-04-21
- 2021-04-24
- 2021-05-08
- 2021-05-20
- 2021-05-27
-
2021-07-17
Survey response — 3 months, dose 2MedDRA: Heart rate decreased, Hypertension — 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 · Emergency room or emergency department visit, HospitalizationFree text: High Blood Pressure Lower Heart RateMedDRA releases: 2024-11 · check-in free text available
-
2021-07-17
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 pr1 call case(s)
- 2021-07-20
- 2021-07-21
-
2021-07-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-17 | Successful 2021-07-22 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): dehydrated- dry mouth
Release 9 — 3 months, dose 2
Symptoms: High Blood Pressure Lower Heart Rate
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 decreased | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SRO | Dehydration | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release