6JM-41775-47838
2 vaccinations
1 coded response
20 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 553 / MN
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
-
2021-01-27
Dose 1 — Moderna
-
2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-12
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
-
2021-03-31
Survey response — day 35, dose 2MedDRA: Abortion spontaneous, Surgery — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Miscarriage · Healthcare visit (other): Outpatient surgeryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-24
- 2021-05-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-31 | Unsuccessful |
Free text
Release 6 — day 35, dose 2
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 |
|---|---|---|---|---|
| HCVO | Surgery | ✓ | ✓ | ✓ |
| SD | Abortion spontaneous | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release