7FL-16457-80344
1 vaccination
1 coded response
1 check-in
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 126 / NY
- Registered
- 2022-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
HUP-85041-45452
Child or adolescent in my care · Male · 2022-01-04
Timeline
-
2021-11-20
Dose 1 — Moderna
-
2022-01-04
Registered in v-safe
-
2022-01-04
Survey response — day 42, dose 1MedDRA: Chills, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Vomiting — 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 · Outpatient clinic or urgent care clinic visitFree text: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, Sore throat, Congestion or runny nose, Nausea or vomiting, .DiarrheaMedDRA releases: 2024-11 · check-in free text available
-
2022-01-04
Report sent to call center — day 42, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-04
-
2022-01-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-04 | Successful 2022-01-06 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — day 42, dose 1
Symptoms: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, Sore throat, Congestion or runny nose, Nausea or vomiting, .Diarrhea
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 | Chills | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release