5SD-23752-17722
4 vaccinations
2 coded responses
37 check-ins
1 free-text entry
2 call cases
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 891 / NV
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KRA-76035-95414
Child or adolescent in my care · Male · 2022-10-18
Timeline
-
2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Moderna
- 2021-01-07
-
2021-01-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-01-09
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Chills, Joint pains, Muscle or body achesAdult check-in
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-21
- 2021-01-28
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-06
-
2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Joint pains, Muscle or body achesAdult check-in
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-20
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-05-06
-
2021-08-05
Survey response — 6 months, dose 2MedDRA: Breast mass, Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Lump found in breast, dense breasts, lymph nodes swollen on side received vaccination · Healthcare visit (other): Diagnostic imagingMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-05
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-11-05
Dose 3 — Moderna
-
2021-11-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-04
-
2022-10-18
Dose 4 — ModernaCo-administered: Flu
- 2022-10-18
-
2022-10-19
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-12-01
- 2023-01-17
-
2023-04-18
Survey response — 6 months, dose 4MedDRA: Caesarean section — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-18
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2023-04-19
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 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-10-18 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-05 | Successful 2021-11-23 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-04-18 | Successful 2023-04-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 9 — 6 months, dose 2
Symptoms: Lump found in breast, dense breasts, lymph nodes swollen on side received vaccination
Healthcare visit (other): Diagnostic imaging
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | · | ✓ |
| SD | Breast mass | ✓ | · | ✓ |
| SD | Caesarean section | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release