63E-14430-78677
3 vaccinations
1 coded response
33 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 774 / TX
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-16
- 2021-01-23
-
2021-01-29
Dose 2 — Moderna
- 2021-01-29
- 2021-01-30
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Fatigue or tirednessAdult check-in
- 2021-02-01
-
2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-14
- 2021-05-01
- 2021-08-02
-
2021-11-06
Dose 3 — Moderna
-
2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-11
- 2021-11-20
- 2021-11-27
- 2021-12-06
- 2021-12-11
- 2021-12-18
-
2022-02-05
Survey response — 3 months, dose 3MedDRA: Cough, Ear discomfort, Headache, Nasal congestion, Oropharyngeal pain, Respiratory tract congestion, Somnolence, Tinnitus — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throat, headache, head congestion, stuffy nose, clogged ear, ringing ear, sleepy, coughMedDRA releases: 2024-11 · check-in free text available
-
2022-02-05
Report sent to call center — 3 months, dose 3Be 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)
-
2022-03-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-07
- 2022-11-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-01-29 | Moderna | |
| 3 | 2021-11-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-05 | Successful 2022-03-30 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 11 — 3 months, dose 3
Symptoms: Sore throat, headache, head congestion, stuffy nose, clogged ear, ringing ear, sleepy, 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 | Ear discomfort | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release