C6S-11187-53650
1 vaccination
0 coded responses
4 check-ins
0 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 104 / NY
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
-
2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-13
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-18
- 2021-01-18
- 2021-01-25
-
2021-02-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna |
Call center
2 call center cases
2 successful
Free text
None.
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
No MedDRA codes.