7BQ-33875-31787
2 vaccinations
4 coded responses
22 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 891 / NV
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-15
Registered in v-safe
-
2021-02-15
Dose 1 — Moderna
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Good · Site: PainFree text: TinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Survey response — days 1–6 daily, dose 1MedDRA: Hypoaesthesia, Tinnitus — Feeling: Good · Site: Pain, Redness, SwellingFree text: Tinnitus and face numbingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
-
2021-02-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-02-22
- 2021-03-03
-
2021-03-10
Survey response — day 21, dose 1MedDRA: Headache, Rhinorrhoea — Feeling: FairFree text: Runny nose, headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Dose 2 — Moderna
- 2021-03-15
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-03-17
- 2021-03-18
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
-
2021-06-14
Survey response — 3 months, dose 2MedDRA: Abdominal pain upper, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Stomachache · Healthcare visit (other): Urgent careMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-14
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional2 call case(s)
-
2021-06-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-06-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-09-13
- 2022-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-14 | Successful 2021-06-23 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-06-14 | Successful 2021-06-23 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Tinnitus
Systemic reaction (other): Tinnitus and face numbing
Release 5 — day 21, dose 1
Symptoms: Runny nose, headache
Release 9 — 3 months, 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 | Office visit | ✓ | ✓ | ✓ |
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release