73A-31258-15369
5 vaccinations
3 coded responses
56 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 960 / CA
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-06
Dose 2 — Moderna
-
2021-02-08
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 do your normal daily activitiesAdult check-in
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · HeadacheAdult check-in
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-22
- 2021-02-27
- 2021-03-06
- 2021-03-15
- 2021-03-22
- 2021-05-08
-
2021-08-07
Survey response — 6 months, dose 2MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend schoolFree text: I miscarried a pregnancyMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-16
Dose 3 — Moderna
- 2021-12-06
- 2021-12-07
- 2021-12-16
- 2021-12-21
- 2021-12-28
- 2022-02-15
- 2022-05-19
-
2022-08-11
Dose 4 — Moderna
- 2022-08-12
- 2022-08-13
-
2022-08-14
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Joint painsAdult check-in
- 2022-08-15
-
2022-08-16
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Itching · Fever · NoneAdult check-in
- 2022-08-17
-
2022-08-18
Survey response — day 7, dose 4MedDRA: Cough — Feeling: FairFree text: CoughMedDRA releases: 2024-11 · check-in free text available
-
2022-08-25
Survey response — day 14, dose 4MedDRA: Abdominal pain upper, Cough, Headache, Productive cough, Vomiting — Feeling: Good · 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: Cough headache phlegm stomach ache EmesisMedDRA releases: 2024-11 · check-in free text available
-
2022-08-25
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-08-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-01
- 2022-09-08
- 2022-09-17
- 2022-09-22
- 2022-11-10
-
2022-12-15
Dose 5 — Pfizer-BioNTech
- 2022-12-17
- 2022-12-18
- 2022-12-19
- 2022-12-20
- 2022-12-21
- 2022-12-22
- 2022-12-29
- 2023-01-05
- 2023-01-14
- 2023-01-19
- 2023-01-26
- 2023-03-16
- 2023-06-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-06 | Moderna | |
| 3 | 2021-11-16 | Moderna | No |
| 4 | 2022-08-11 | Moderna | No |
| 5 | 2022-12-15 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-25 | Successful 2022-08-26 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 9 — 6 months, dose 2
Symptoms: I miscarried a pregnancy
Release 12 — day 7, dose 4
Systemic reaction (other): Cough
Release 12 — day 14, dose 4
Symptoms: Cough headache phlegm stomach ache Emesis
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 | Abdominal pain upper | · | · | ✓ |
| SD | Abortion spontaneous | ✓ | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release