9UM-61710-38177
3 vaccinations
3 coded responses
24 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 221 / VA
- Registered
- 2021-03-20
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-20
Registered in v-safe
-
2021-03-20
Dose 1 — Moderna
-
2021-03-20
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-03-22
-
2021-03-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Fatigue or tiredness, NauseaAdult check-in
-
2021-03-24
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-03-27
-
2021-04-03
Survey response — day 14, dose 1MedDRA: Axillary pain — Feeling: GoodFree text: Underarm pain in vaccination arm. Pain lasted two days and then diminished.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
-
2021-04-19
Dose 2 — Moderna
- 2021-04-19
-
2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-22
- 2021-04-23
- 2021-04-25
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-26
- 2021-06-02
- 2021-07-21
- 2021-10-18
-
2021-11-29
Dose 3 — Moderna
- 2022-04-19
-
2022-05-30
Survey response — 6 months, dose 3MedDRA: Anaemia postoperative, Blood loss anaemia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Blood loss and anemia due to surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-11-30
Survey response — 12 months, dose 3MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, 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: CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-11-30
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-12-01
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-19 | Moderna | |
| 3 | 2021-11-29 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 6 — day 14, dose 1
Symptoms: Underarm pain in vaccination arm. Pain lasted two days and then diminished.
Release 11 — 6 months, dose 3
Symptoms: Blood loss and anemia due to surgery
Release 12 — 12 months, dose 3
Symptoms: Covid
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 | Anaemia postoperative | · | · | ✓ |
| SD | Axillary pain | ✓ | ✓ | ✓ |
| SD | Blood loss anaemia | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release