6WT-73168-25408
5 vaccinations
2 coded responses
53 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 535 / WI
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JR3-28510-30042
Child or adolescent in my care · Female · 2022-06-30
PC7-16855-13451
Child or adolescent in my care · Male · 2023-02-06
Timeline
-
2021-03-24
Registered in v-safe
-
2021-03-24
Dose 1 — Moderna
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-07
- 2021-04-14
-
2021-04-21
Dose 2 — Moderna
- 2021-04-21
-
2021-04-22
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-07-21
- 2021-10-20
-
2021-12-03
Dose 3 — Moderna
- 2021-12-03
-
2021-12-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-12-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-12-06
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-07
- 2021-12-08
-
2021-12-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2021-12-31
- 2022-01-07
-
2022-01-14
Survey response — day 42, dose 3MedDRA: Chills, Fatigue, Nasopharyngitis, Oropharyngeal pain, Pain, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Common cold most likely - congestion, sore throat, sinus pressure, chills, fatigue, body ache. PCR test for COVID-19 several days after symptoms started was negative · Healthcare visit (other): COVID testMedDRA releases: 2024-11 · check-in free text available
-
2022-01-14
Report sent to call center — day 42, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-01-18
- 2022-01-21
- 2022-03-04
-
2022-05-13
Dose 4 — Moderna
- 2022-06-05
-
2022-11-27
Dose 5 — ModernaCo-administered: Flu
-
2022-11-28
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2022-11-29
- 2022-11-30
- 2022-12-01
- 2022-12-02
- 2022-12-04
- 2022-12-11
- 2022-12-18
- 2022-12-25
- 2023-01-03
- 2023-01-08
-
2023-02-28
Survey response — 3 months, dose 5MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Sinus headache — Feeling: FairMedDRA releases: 2024-11
- 2023-05-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-24 | Moderna | |
| 2 | 2021-04-21 | Moderna | |
| 3 | 2021-12-03 | Moderna | No |
| 4 | 2022-05-13 | Moderna | No |
| 5 | 2022-11-27 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-14 | Unsuccessful |
Free text
Release 10 — day 42, dose 3
Symptoms: Common cold most likely - congestion, sore throat, sinus pressure, chills, fatigue, body ache. PCR test for COVID-19 several days after symptoms started was negative
Healthcare visit (other): COVID test
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 | SARS-CoV-2 test | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release