98Z-31206-67367
5 vaccinations
5 coded responses
67 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 630 / MO
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
WCT-31829-64331
Child or adolescent in my care · Male · 2022-07-01
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
-
2021-03-02
Health check-in — day 0, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
-
2021-03-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-03-04
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2021-03-06
-
2021-03-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-03-09
- 2021-03-16
- 2021-03-23
-
2021-03-30
Dose 2 — Moderna
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-06-29
- 2021-09-28
-
2021-10-23
Dose 3 — ModernaCo-administered: Flu
-
2021-10-24
Survey response — days 1–6 daily, dose 3MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work or attend schoolFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-29
- 2021-12-04
-
2022-01-22
Survey response — 3 months, dose 3MedDRA: Headache, Office visit, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Headaches, heart palpitations · Healthcare visit (other): Regular doctor's visit in personMedDRA releases: 2024-11 · check-in free text available
-
2022-01-22
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-01-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-23
-
2022-05-27
Dose 4 — Moderna
-
2022-05-28
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-05-29
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
-
2022-05-30
Survey response — days 1–6 daily, dose 4MedDRA: Insomnia — Feeling: Good · Site: Pain, Redness, Swelling · Joint painsFree text: InsomniaMedDRA releases: 2024-11 · check-in free text available
-
2022-05-31
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · Abdominal painAdult check-in
- 2022-06-01
- 2022-06-02
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-07-08
- 2022-08-26
-
2022-09-30
Dose 5 — ModernaCo-administered: Flu
-
2022-09-30
Health check-in — day 0, dose 5Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2022-10-01
Survey response — days 1–6 daily, dose 5MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Slightly increased heart rateMedDRA releases: 2024-11 · check-in free text available
-
2022-10-02
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2022-10-03
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-07
- 2022-10-14
-
2022-10-21
Survey response — day 21, dose 5MedDRA: Abortion spontaneous, Biochemical pregnancy — Feeling: FairFree text: Had a chemical pregnancy (very early miscarriage)MedDRA releases: 2024-11 · check-in free text available
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-12-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-10-23 | Moderna | Flu |
| 4 | 2022-05-27 | Moderna | No |
| 5 | 2022-09-30 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-22 | Successful 2022-01-27 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Dizziness
Release 11 — 3 months, dose 3
Symptoms: Headaches, heart palpitations
Healthcare visit (other): Regular doctor's visit in person
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Insomnia
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slightly increased heart rate
Release 12 — day 21, dose 5
Symptoms: Had a chemical pregnancy (very early 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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Biochemical pregnancy | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Heart rate increased | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release