6XX-31229-11348
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 303 / GA
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
-
2020-12-29
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Headache — Feeling: Good · Site: PainFree text: Did have headache/chills last night, none todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-14
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
-
2021-01-25
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Redness · Fever · Chills, Fatigue or tirednessAdult check-in
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-31
-
2021-02-01
Survey response — day 7, dose 2MedDRA: Night sweats — Feeling: Fair · Fatigue or tiredness, NauseaFree text: Night sweatsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-15
- 2021-02-24
- 2021-03-01
- 2021-03-08
- 2021-04-28
- 2021-07-28
-
2022-01-25
Survey response — 12 months, dose 2MedDRA: SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sinusitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sinus infection (multiple negative COVID tests) Tested positive for COVID on rapid and PCR after sinusitis mostly resolvedMedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-25 | Successful 2022-01-27 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Did have headache/chills last night, none today
Release 3 — day 7, dose 2
Systemic reaction (other): Night sweats
Release 11 — 12 months, dose 2
Symptoms: Sinus infection (multiple negative COVID tests) Tested positive for COVID on rapid and PCR after sinusitis mostly resolved
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 | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release