CEU-10823-51067
4 vaccinations
5 coded responses
24 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 190 / PA
- Registered
- 2021-04-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-04-12
Registered in v-safe
- 2021-04-12
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
-
2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: CoughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion — Feeling: Poor · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: CongestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Survey response — day 7, dose 2MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Headache, Fatigue or tirednessFree text: Tested positive for CovidMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
-
2021-05-05
Survey response — day 21, dose 2MedDRA: Cyclic vomiting syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cyclic vomitingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-05
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-12
Survey response — day 28, dose 2MedDRA: Gastritis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: GastritisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-12
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-19
- 2021-05-26
- 2021-07-14
- 2021-10-13
-
2021-12-10
Dose 3 — Moderna
-
2022-04-12
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-12
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-14
-
2022-09-26
Dose 4 — Pfizer-BioNTech
- 2022-09-27
- 2022-09-28
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-11-02
- 2022-11-07
- 2022-12-26
- 2023-03-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
| 4 | 2022-09-26 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Cough
Systemic reaction (other): Congestion
Release 7 — day 7, dose 2
Systemic reaction (other): Tested positive for Covid
Release 8 — day 21, dose 2
Symptoms: Cyclic vomiting
Release 8 — day 28, dose 2
Symptoms: Gastritis
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 | Cyclic vomiting syndrome | ✓ | ✓ | ✓ |
| SD | Gastritis | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release