5NB-15555-08488
4 vaccinations
3 coded responses
22 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 913 / CA
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-01
Registered in v-safe
-
2021-02-01
Dose 1 — Moderna
- 2021-02-01
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-08
-
2021-03-01
Dose 2 — Moderna
-
2021-03-01
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Eye pruritus, Periorbital swelling — Feeling: Good · Site: Pain, Swelling · Joint pains, Fatigue or tirednessFree text: Itchy puffy eyesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · HeadacheAdult check-in
- 2021-03-04
- 2021-03-06
- 2021-03-08
- 2021-03-24
- 2021-03-29
- 2021-04-07
-
2021-06-02
Survey response — 3 months, dose 2MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sore throat, cough, cold like symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-02
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-01
-
2021-09-17
Dose 3 — Moderna
- 2021-10-29
-
2022-03-31
Dose 4 — Moderna
- 2022-04-14
- 2022-04-21
- 2022-04-28
- 2022-09-29
-
2023-03-31
Survey response — 12 months, dose 4MedDRA: Viral infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-31
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-03
- 2023-04-03
- 2023-04-06
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna | |
| 2 | 2021-03-01 | Moderna | |
| 3 | 2021-09-17 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-02 | Unsuccessful | |
| 2023-03-31 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Itchy puffy eyes
Release 8 — 3 months, dose 2
Symptoms: Sore throat, cough, cold like symptoms
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 | Cough | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Eye pruritus | ✓ | ✓ | ✓ |
| SRO | Periorbital swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release