9DZ-14881-60904
4 vaccinations
4 coded responses
52 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 786 / TX
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
255-70161-17931
Child or adolescent in my care · Male · 2021-12-02
CBX-41037-83873
Child or adolescent in my care · Male · 2022-08-05
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-02-27
Registered in v-safe
-
2021-02-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-11
- 2021-03-18
-
2021-03-25
Dose 2 — Moderna
- 2021-03-25
-
2021-03-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, NauseaAdult check-in
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
-
2021-04-23
Survey response — day 28, dose 2MedDRA: Nasopharyngitis, Pneumonia bacterial — Feeling: Fair · Be unable to work, 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: Bacterial pneumonia that came from a coldMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — day 28, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-29
- 2021-05-06
- 2021-06-25
- 2021-09-24
-
2021-12-02
Dose 3 — Moderna
- 2021-12-02
-
2021-12-03
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-12-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-05
- 2021-12-07
- 2021-12-08
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2021-12-30
- 2022-01-06
- 2022-01-13
-
2022-03-03
Survey response — 3 months, dose 3MedDRA: COVID-19, Fatigue — Feeling: Fair · 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: Fatigue following a covid infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-03-03
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-04
Call successfulParticipant prefers to complete VAERS report online
- 2022-06-03
-
2022-10-19
Dose 4 — ModernaCo-administered: Flu
-
2022-10-19
Survey response — day 0, dose 4MedDRA: Injection site warmth — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Mild warmth at and around the injection siteMedDRA releases: 2024-11 · check-in free text available
-
2022-10-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-21
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-10-26
-
2022-11-02
Survey response — day 14, dose 4MedDRA: Influenza A virus test positive — 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: Tested positive for flu AMedDRA releases: 2024-11 · check-in free text available
-
2022-11-02
Report sent to call center — day 14, dose 4Be 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)
-
2022-11-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2022-12-01
- 2023-01-18
- 2023-04-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
| 4 | 2022-10-19 | Moderna | Flu |
Call center
3 call center cases
3 successful
Free text
Release 7 — day 28, dose 2
Symptoms: Bacterial pneumonia that came from a cold
Release 11 — 3 months, dose 3
Symptoms: Fatigue following a covid infection
Release 12 — day 0, dose 4
Systemic reaction (other): Mild warmth at and around the injection site
Release 12 — day 14, dose 4
Symptoms: Tested positive for flu A
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 | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Influenza A virus test positive | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Pneumonia bacterial | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release