6BA-19417-73303
3 vaccinations
8 coded responses
36 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 900 / CA
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
DPV-33492-31648
Child or adolescent in my care · Male · 2021-12-04
Timeline
-
2021-04-03
Dose 1 — Janssen/Johnson & Johnson
-
2021-04-05
Registered in v-safe
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-10
- 2021-04-17
-
2021-04-26
Survey response — day 21, single doseMedDRA: Headache, Neck pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Neck pain and headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Report sent to call center — day 21, single doseGet care from a doctor or other healthcare professional1 call case(s)
- 2021-05-01
- 2021-05-09
- 2021-05-15
- 2021-05-25
- 2021-07-03
-
2021-11-02
Dose 2 — Moderna
-
2021-11-02
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-06
- 2021-11-07
- 2021-11-09
- 2021-11-18
- 2021-11-23
- 2021-11-30
- 2021-12-09
- 2021-12-14
- 2022-02-01
- 2022-05-05
-
2022-10-13
Dose 3 — Moderna
-
2022-10-13
Survey response — day 0, dose 3MedDRA: Dizziness — Feeling: GoodFree text: Light headedMedDRA releases: 2024-11 · check-in free text available
-
2022-10-14
Survey response — days 1–6 daily, dose 3MedDRA: Neck pain — Feeling: Fair · Site: Pain · Headache, Muscle or body achesFree text: Neck painMedDRA releases: 2024-11 · check-in free text available
- 2022-10-16
-
2022-10-18
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Insomnia — Feeling: Fair · HeadacheFree text: Irritated by headache and insomniaMedDRA releases: 2024-11 · check-in free text available
-
2022-10-19
Survey response — days 1–6 daily, dose 3MedDRA: Neck pain — Feeling: Fair · Headache, NauseaFree text: Neck painMedDRA releases: 2024-11 · check-in free text available
-
2022-10-20
Survey response — day 7, dose 3MedDRA: Neck pain — Feeling: GoodFree text: Neck painMedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-10
-
2022-11-24
Survey response — day 42, dose 3MedDRA: Nasopharyngitis — Feeling: GoodFree text: Sinus ColdMedDRA releases: 2024-11 · check-in free text available
- 2023-01-14
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-03 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-02 | Moderna | No |
| 3 | 2022-10-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-26 | Unsuccessful |
Free text
Release 8 — day 21, single dose
Symptoms: Neck pain and headache
Release 12 — day 0, dose 3
Systemic reaction (other): Light headed
Release 12 — days 1–6 daily, dose 3
Systemic reaction (other): Neck pain
Systemic reaction (other): Irritated by headache and insomnia
Systemic reaction (other): Neck pain
Release 12 — day 7, dose 3
Systemic reaction (other): Neck pain
Release 12 — day 42, dose 3
Symptoms: Sinus Cold
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 | Headache | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Neck pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release