8QM-14929-90689
3 vaccinations
5 coded responses
36 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 112 / NY
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Registered dependents
MXT-31099-90989
Child or adolescent in my care · Female · 2022-06-25
PVA-66261-17706
Child or adolescent in my care · Female · 2022-06-25
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
-
2021-01-11
Survey response — day 14, dose 1MedDRA: Chest discomfort, Fatigue, Rhinorrhoea, Sneezing — Feeling: GoodFree text: Fatigue, sneezing/rhinorrhea ,chest tightness one day, no cough or feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-20
-
2021-01-25
Survey response — day 28, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Rhinorrhea/??allergic rhinitis?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-26
Dose 2 — Moderna
-
2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Decreased appetite, Malaise, Nausea, Pyrexia — Feeling: Good · Site: Pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Fever, chills, nausea, fatigue, malaise, anorexia 12 hrs after dose shot, lasted 24 hrs then resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
- 2021-07-27
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-05
- 2021-11-10
- 2021-11-17
-
2021-11-24
Survey response — day 28, dose 3MedDRA: Malaise, Rhinorrhoea — Feeling: GoodFree text: Runny nose, malaiseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
- 2022-01-26
- 2022-04-27
-
2022-10-27
Survey response — 12 months, dose 3MedDRA: Abortion spontaneous, Fungal infection, Respiratory symptom — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: URI symptoms Yeast infection MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2022-10-27
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-26 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-27 | Unsuccessful |
Free text
Release 1 — day 14, dose 1
Symptoms: Fatigue, sneezing/rhinorrhea ,chest tightness one day, no cough or fever
Release 2 — day 28, dose 1
Symptoms: Rhinorrhea/??allergic rhinitis?
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Fever, chills, nausea, fatigue, malaise, anorexia 12 hrs after dose shot, lasted 24 hrs then resolved.
Release 10 — day 28, dose 3
Symptoms: Runny nose, malaise
Release 12 — 12 months, dose 3
Symptoms: URI symptoms Yeast infection Miscarriage
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 | Abortion spontaneous | · | · | ✓ |
| SD | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Fungal infection | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release