CAW-49675-14661
4 vaccinations
3 coded responses
28 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 957 / CA
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
6FV-12393-71599
Adult relative or friend · Male · 2021-11-21
W7H-85073-52904
Child or adolescent in my care · Male · 2021-11-21
Timeline
-
2021-01-28
Dose 1 — Moderna
-
2021-02-26
Dose 2 — Moderna
-
2021-02-27
Registered in v-safe
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Pyrexia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Had sudden chills and fever the evening of Sunday 2/28.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-14
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-05-28
- 2021-08-29
-
2021-11-20
Dose 3 — Pfizer-BioNTech
-
2021-11-21
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
-
2021-11-22
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
-
2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tirednessAdult check-in
-
2021-11-24
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: GoodFree text: Swollen lymph node under armpit since SundayMedDRA releases: 2024-11 · check-in free text available
- 2021-11-25
- 2021-11-27
- 2021-12-04
- 2021-12-11
- 2021-12-18
- 2021-12-31
- 2022-01-02
- 2022-02-21
- 2022-05-21
-
2022-10-14
Dose 4 — ModernaCo-administered: Flu
-
2022-11-20
Survey response — 12 months, dose 3MedDRA: Abortion spontaneous — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2022-11-20
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-11-20 | Pfizer-BioNTech | No |
| 4 | 2022-10-14 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-20 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Had sudden chills and fever the evening of Sunday 2/28.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swollen lymph node under armpit since Sunday
Release 12 — 12 months, dose 3
Symptoms: Miscarriage
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 | Abortion spontaneous | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release