5MS-13334-33473
3 vaccinations
5 coded responses
31 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 454 / OH
- Registered
- 2021-06-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
7HX-63633-23205
Child or adolescent in my care · Male · 2022-07-28
Timeline
-
2021-06-18
Registered in v-safe
-
2021-06-18
Dose 1 — Moderna
- 2021-06-18
-
2021-06-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-06-20
- 2021-06-21
- 2021-06-22
- 2021-06-23
- 2021-06-24
- 2021-06-25
- 2021-07-02
- 2021-07-09
- 2021-07-16
-
2021-07-19
Dose 2 — Moderna
- 2021-07-23
- 2021-07-24
- 2021-07-25
- 2021-07-26
- 2021-08-02
- 2021-08-09
- 2021-08-16
- 2021-08-23
- 2021-08-30
- 2021-10-18
-
2022-01-04
Dose 3 — Moderna
- 2022-01-10
-
2022-01-13
Survey response — day 7, dose 3MedDRA: Delivery — Feeling: GoodFree text: Gave birth on (b)(6)MedDRA releases: 2024-11 · check-in free text available
-
2022-01-18
Survey response — day 14, dose 3MedDRA: Eclampsia — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: EclampsiaMedDRA releases: 2024-11 · check-in free text available
-
2022-01-18
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-01-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-25
- 2022-02-01
- 2022-02-08
- 2022-02-15
-
2022-04-05
Survey response — 3 months, dose 3MedDRA: Cough, Malaise, Pyrexia, Sinus congestion — Feeling: GoodFree text: Sinus congestion, low grade fever, cough, malaiseMedDRA releases: 2024-11 · check-in free text available
-
2022-07-05
Survey response — 6 months, dose 3MedDRA: Cough, Pre-existing disease, Respiratory tract congestion, Sneezing, Unevaluable event, Upper-airway cough syndrome — Feeling: GoodFree text: Sinus/allergy related breezing, congestion/post nasal drip and coughMedDRA releases: 2024-11 · check-in free text available
-
2023-01-04
Survey response — 12 months, dose 3MedDRA: Bronchitis, Influenza like illness — 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 · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-01-04
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-01-05
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-18 | Moderna | |
| 2 | 2021-07-19 | Moderna | No |
| 3 | 2022-01-04 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-18 | Successful 2022-01-19 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-01-04 | Successful 2023-01-05 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — day 7, dose 3
Release 10 — day 14, dose 3
Symptoms: Eclampsia
Release 11 — 3 months, dose 3
Symptoms: Sinus congestion, low grade fever, cough, malaise
Release 12 — 6 months, dose 3
Symptoms: Sinus/allergy related breezing, congestion/post nasal drip and cough
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 | Bronchitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Eclampsia | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Delivery | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release