6GW-55801-81965
4 vaccinations
3 coded responses
50 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 212 / MD
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
RSX-27961-95927
Child or adolescent in my care · Female · 2022-07-11
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-02-26
Dose 2 — Moderna
-
2021-02-26
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · HeadacheAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-05-28
- 2021-08-27
-
2021-10-23
Dose 3 — Moderna
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · HeadacheFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-11-06
-
2021-11-13
Survey response — day 21, dose 3MedDRA: Cough, Nasopharyngitis, Respiratory tract congestion — 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 visitFree text: A cold with cough and congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Report sent to call center — day 21, dose 3Be 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 · 1 call case(s)
-
2021-11-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-20
- 2021-11-29
- 2021-12-04
- 2022-01-22
- 2022-04-23
-
2022-09-29
Dose 4 — Pfizer-BioNTechCo-administered: Flu
-
2022-10-01
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-13
- 2022-10-22
- 2022-10-27
- 2022-11-03
- 2022-11-10
-
2022-12-29
Survey response — 3 months, dose 4MedDRA: Nasopharyngitis, Respiratory syncytial virus infection — 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 · Telehealth, virtual health, or email health consultationFree text: RSV, coldsMedDRA releases: 2024-11 · check-in free text available
-
2022-12-29
Report sent to call center — 3 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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-12-30
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-09-29 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-13 | Successful 2021-11-17 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-12-29 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore throat
Release 10 — day 21, dose 3
Symptoms: A cold with cough and congestion
Release 12 — 3 months, dose 4
Symptoms: RSV, colds
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 | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release