9XB-12841-58143
2 vaccinations
2 coded responses
15 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 020 / MA
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-31
Registered in v-safe
-
2020-12-31
Dose 1 — Moderna
-
2020-12-31
Survey response — day 0, dose 1MedDRA: Ear pain — Feeling: Good · Site: PainFree text: R ear sore (same side as injection)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-01
- 2021-01-03
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-21
-
2021-01-28
Dose 2 — Moderna
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-04-29
-
2021-07-29
Survey response — 6 months, dose 2MedDRA: Caesarean section, Emergency care, Polyhydramnios, Pregnancy — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Developed polyhydramnios at 38 weeks pregnant requiring an emergency c-section with baby requiring nicu care.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-29
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-02
- 2021-08-03
- 2021-08-04
- 2021-08-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna | |
| 2 | 2021-01-28 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): R ear sore (same side as injection)
Release 9 — 6 months, dose 2
Symptoms: Developed polyhydramnios at 38 weeks pregnant requiring an emergency c-section with baby requiring nicu care.
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 | Caesarean section | ✓ | · | ✓ |
| SD | Emergency care | ✓ | · | ✓ |
| SD | Polyhydramnios | ✓ | · | ✓ |
| SD | Pregnancy | ✓ | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release