675-12909-42488
4 vaccinations
3 coded responses
40 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 303 / GA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
-
2021-02-18
Dose 2 — Moderna
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Palpitations, Poor quality sleep, Somnolence — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Did not sleep well, woke up with racing heart and chillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-23
- 2021-02-24
- 2021-02-27
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-05-20
- 2021-08-19
-
2021-11-28
Dose 3 — ModernaCo-administered: Flu
- 2021-11-28
-
2021-11-30
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: I accidentally selected that I was pregnant in the initial survey, but I am not and have not been. Sorry!MedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-02
- 2021-12-03
- 2021-12-06
- 2021-12-12
- 2021-12-19
- 2021-12-26
- 2022-01-02
- 2022-01-09
- 2022-02-28
-
2022-10-29
Dose 4 — Pfizer-BioNTechCo-administered: Flu
-
2022-10-30
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-11-21
- 2022-11-28
-
2023-04-29
Survey response — 6 months, dose 4MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-29
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
-
2023-05-01
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-11-28 | Moderna | Flu |
| 4 | 2022-10-29 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-04-29 | Successful 2023-05-01 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Did not sleep well, woke up with racing heart and chills
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I accidentally selected that I was pregnant in the initial survey, but I am not and have not been. Sorry!
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 | Abortion spontaneous | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | · | ✓ |
| SRO | Somnolence | ○ | ✓ | ○ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release