5XF-16108-91156
3 vaccinations
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 452 / OH
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-09
Registered in v-safe
-
2021-01-09
Dose 1 — Moderna
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-25
-
2021-02-06
Dose 2 — Moderna
- 2021-04-10
- 2021-07-10
-
2021-11-05
Dose 3 — Moderna
- 2021-11-07
- 2021-11-08
- 2021-11-14
- 2021-11-28
-
2021-12-05
Survey response — day 28, dose 3MedDRA: Upper-airway cough syndrome — Feeling: FairFree text: Drippage down my throatMedDRA releases: 2024-11 · check-in free text available
-
2022-05-08
Survey response — 6 months, dose 3MedDRA: COVID-19 — 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 consultationFree text: COVID-19MedDRA releases: 2024-11 · check-in free text available
-
2022-05-08
Report sent to call center — 6 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)
- 2022-05-10
-
2022-05-10
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 | 2021-01-09 | Moderna | |
| 2 | 2021-02-06 | Moderna | No |
| 3 | 2021-11-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-08 | Successful 2022-05-10 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — day 28, dose 3
Symptoms: Drippage down my throat
Release 11 — 6 months, dose 3
Symptoms: COVID-19
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 | COVID-19 | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release