9YH-29950-16632
3 vaccinations
4 coded responses
38 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 841 / UT
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
Q64-32381-88080
Child or adolescent in my care · Male · 2022-07-06
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
-
2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaFree text: DizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-28
- 2021-02-04
-
2021-02-11
Dose 2 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-05-13
-
2021-08-12
Survey response — 6 months, dose 2MedDRA: Cough, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good · Be unable to work or attend schoolFree text: Sore throat, cough, congestionMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-27
Dose 3 — ModernaCo-administered: Flu
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
-
2021-11-24
Survey response — day 28, dose 3MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: GoodFree text: Stuffy nose, sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Ruptured ectopic pregnancy — 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 · Emergency room or emergency department visit, HospitalizationFree text: Ruptured ectopic pregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 3 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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-01-27
- 2022-04-27
- 2022-10-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-10-27 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-26 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Dizzy
Release 9 — 6 months, dose 2
Symptoms: Sore throat, cough, congestion
Release 10 — day 28, dose 3
Symptoms: Stuffy nose, sore throat
Release 11 — 3 months, dose 3
Symptoms: Ruptured ectopic pregnancy
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 | Cough | ✓ | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | Ruptured ectopic pregnancy | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release