653-19988-00216
4 vaccinations
3 coded responses
28 check-ins
3 free-text entries
1 call case
- Sex
- —
- Age at first dose
- 31-35
- ZIP prefix
- 921 / CA
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
-
2021-01-19
Health check-in — day 7, dose 1Feeling: Good · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-27
Survey response — day 14, dose 1MedDRA: Herpes simplex — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Herpes simplex breakout (oral)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-03
-
2021-02-08
Dose 2 — Moderna
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-24
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-04-24
- 2021-08-09
-
2021-10-15
Dose 3 — Moderna
- 2021-10-23
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-21
- 2021-11-28
- 2022-01-14
-
2022-04-15
Survey response — 6 months, dose 3MedDRA: Pregnancy — Feeling: FairFree text: PregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-09-17
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-08
-
2022-10-17
Survey response — day 28, dose 4MedDRA: Unevaluable event — Feeling: GoodFree text: IneMedDRA releases: 2024-11 · check-in free text available
- 2022-10-22
- 2022-12-19
- 2023-03-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-15 | Moderna | No |
| 4 | 2022-09-17 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-27 | Unsuccessful |
Free text
Release 2 — day 14, dose 1
Symptoms: Herpes simplex breakout (oral)
Release 11 — 6 months, dose 3
Symptoms: Pregnancy
Release 12 — day 28, dose 4
Symptoms: Ine
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 | Herpes simplex | ✓ | ✓ | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release