BLA-25063-17118
2 vaccinations
3 coded responses
18 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 900 / CA
- Registered
- 2021-03-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-20
Dose 1 — Moderna
-
2021-03-29
Registered in v-safe
- 2021-03-29
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Moderna
- 2021-04-17
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-05-17
- 2021-05-22
-
2021-05-29
Survey response — day 42, dose 2MedDRA: Menstruation irregular — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Irregular menstruationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-29
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-17
Survey response — 3 months, dose 2MedDRA: Pituitary tumour benign — Feeling: GoodFree text: Pituitary AdonemaMedDRA releases: 2024-11 · check-in free text available
-
2021-10-18
Survey response — 6 months, dose 2MedDRA: Ectopic pregnancy, Fallopian tube perforation, Pituitary tumour — 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 visitFree text: Pituitary tumor and eptopic pregnancy with a ruptured fallopian tube.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-18
Report sent to call center — 6 months, dose 2Be 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 · 1 call case(s)
-
2021-10-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-29 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-10-18 | Successful 2021-10-19 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 8 — day 42, dose 2
Symptoms: Irregular menstruation
Release 9 — 3 months, dose 2
Symptoms: Pituitary Adonema
Release 10 — 6 months, dose 2
Symptoms: Pituitary tumor and eptopic pregnancy with a ruptured fallopian tube.
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 | Ectopic pregnancy | · | · | ✓ |
| SD | Fallopian tube perforation | · | · | ✓ |
| SD | Menstruation irregular | ✓ | ✓ | ✓ |
| SD | Pituitary tumour | · | · | ✓ |
| SD | Pituitary tumour benign | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release