635-17252-67684
2 vaccinations
2 coded responses
6 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 934 / CA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 2 — Moderna
-
2021-03-10
Survey response — day 0, dose 2MedDRA: Abortion spontaneous — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: I had a miscarriage days after receiving the first doseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-09-10
-
2022-03-10
Survey response — 12 months, dose 2MedDRA: Cough, Headache, Malaise, Oropharyngeal pain, Pain — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I am ill approximately every other week for the last year. Experiencing symptoms including headache, body aches, sore throat, cough.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-10
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-11
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-03-10 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-10 | Successful 2022-03-11 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — day 0, dose 2
Systemic reaction (other): I had a miscarriage days after receiving the first dose
Release 11 — 12 months, dose 2
Symptoms: I am ill approximately every other week for the last year. Experiencing symptoms including headache, body aches, sore throat, 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 | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SRO | Abortion spontaneous | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release