5XC-12327-24680
4 vaccinations
3 coded responses
28 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 211 / MD
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
TWQ-32648-23112
Child or adolescent in my care · Male · 2022-07-07
Timeline
-
2021-03-08
Registered in v-safe
-
2021-03-08
Dose 1 — Moderna
-
2021-03-08
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-03-09
- 2021-03-10
-
2021-03-11
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
-
2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-03-14
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to workAdult check-in
- 2021-03-15
- 2021-03-24
- 2021-03-29
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-19
- 2021-07-07
-
2021-10-04
Survey response — 6 months, dose 2MedDRA: Diarrhoea, Nausea, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Nausea, diarrhea, vomitingMedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Dose 3 — Moderna
-
2022-04-07
Survey response — 12 months, dose 2MedDRA: Conjunctivitis, Gastroenteritis viral, Pregnancy, Sinusitis — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Stomach bug, pregnancy, pink eye, sinus infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-04-07
Report sent to call center — 12 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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-11
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-18
Dose 4 — Moderna
- 2022-05-25
-
2022-07-18
Survey response — 3 months, dose 4MedDRA: Kidney infection, Pneumothorax, Sepsis — 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 · Emergency room or emergency department visit, HospitalizationFree text: Kidney infection, sepsis, and a collapsed lungMedDRA releases: 2024-11 · check-in free text available
-
2022-07-18
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-07-20
- 2022-07-20
- 2022-10-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-07 | Successful 2022-04-11 |
Participant prefers to complete VAERS report online |
| 2022-07-18 | Unsuccessful |
Free text
Release 10 — 6 months, dose 2
Symptoms: Nausea, diarrhea, vomiting
Release 11 — 12 months, dose 2
Symptoms: Stomach bug, pregnancy, pink eye, sinus infection
Release 12 — 3 months, dose 4
Symptoms: Kidney infection, sepsis, and a collapsed lung
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 | Conjunctivitis | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Kidney infection | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pneumothorax | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Sepsis | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release