77Y-12086-32423
1 vaccination
2 coded responses
9 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 972 / OR
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-28
Dose 1 — Moderna
-
2020-12-29
Registered in v-safe
- 2020-12-29
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-18
-
2021-03-29
Survey response — 3 months, dose 1MedDRA: Nasal congestion, Oropharyngeal pain, Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Congestion, sore throat, body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-12-28
Survey response — 12 months, dose 1MedDRA: Cough, Fatigue, Oropharyngeal pain, Pain, Respiratory tract congestion — 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 professional · Telehealth, virtual health, or email health consultationFree text: Sore throat, cough, congestion, body aches, fatigueMedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
Report sent to call center — 12 months, dose 1Be 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)
-
2021-12-30
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 |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-28 | Successful 2021-12-30 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 6 — 3 months, dose 1
Symptoms: Congestion, sore throat, body aches
Release 10 — 12 months, dose 1
Symptoms: Sore throat, cough, congestion, body aches, fatigue
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 | Fatigue | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release