6BV-22730-52636
1 vaccination
1 coded response
10 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 146 / NY
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Moderna
- 2020-12-30
-
2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Itching · HeadacheAdult check-in
-
2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Headache, Fatigue or tirednessAdult check-in
- 2021-01-03
- 2021-01-05
- 2021-01-06
- 2021-01-13
- 2021-01-21
- 2021-03-31
-
2021-06-30
Survey response — 6 months, dose 1MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cold symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-30
Report sent to call center — 6 months, dose 1Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-30 | Unsuccessful |
Free text
Release 9 — 6 months, dose 1
Symptoms: Cold symptoms
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 | Nasopharyngitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release