6GS-30290-09022
3 vaccinations
3 coded responses
22 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 488 / MI
- Registered
- 2021-04-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
5UL-33041-96027
Child or adolescent in my care · Male · 2022-06-21
AHT-14434-70520
Child or adolescent in my care · Female · 2022-06-21
Timeline
-
2021-03-25
Dose 1 — Moderna
-
2021-04-22
Dose 2 — Moderna
-
2021-04-23
Registered in v-safe
-
2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-24
-
2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Site: RednessFree text: Pain in armpit on the side of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-04-28
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-29
- 2021-06-03
- 2021-07-22
-
2021-10-21
Survey response — 6 months, dose 2MedDRA: Foetal death — Feeling: GoodFree text: 12.5 week IUFDMedDRA releases: 2024-11 · check-in free text available
-
2021-10-23
Dose 3 — Moderna
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-28
- 2021-12-04
- 2022-01-22
-
2022-04-23
Survey response — 6 months, dose 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: PoorFree text: Sore throat, congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-10-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Pain in armpit on the side of injection
Release 10 — 6 months, dose 2
Symptoms: 12.5 week IUFD
Release 11 — 6 months, dose 3
Symptoms: Sore throat, congestion
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 | Foetal death | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release