64P-28910-77300
1 vaccination
1 coded response
7 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 936 / CA
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
-
2021-01-02
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-03
- 2021-01-04
- 2021-01-06
- 2021-01-09
- 2021-07-03
-
2022-01-02
Survey response — 12 months, dose 1MedDRA: Cough, Headache, Rhinorrhoea — 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: Headache, cough, runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-01-02
Report sent to call center — 12 months, dose 1Be 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)
-
2022-01-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-02 | Successful 2022-01-05 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — 12 months, dose 1
Symptoms: Headache, cough, runny nose
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 | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release