9F9-61470-33053
3 vaccinations
2 coded responses
7 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 802 / CO
- Registered
- 2021-04-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-24
Dose 1 — Moderna
-
2021-04-22
Registered in v-safe
-
2021-04-22
Dose 2 — Moderna
- 2021-04-22
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Condition aggravated, Pre-existing disease, Systemic lupus erythematosus — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to workFree text: I also have lupus and was experiencing fatigue this week before the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-07-24
-
2022-02-05
Dose 3 — Moderna
-
2023-02-07
Survey response — 12 months, dose 3MedDRA: Adverse food reaction, Chest discomfort, Dyspepsia, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-02-07
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-02-08
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-24 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2022-02-05 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I also have lupus and was experiencing fatigue this week before the shot
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 | Adverse food reaction | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Dyspepsia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Systemic lupus erythematosus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release