CFA-10487-19959
4 vaccinations
3 coded responses
16 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 972 / OR
- Registered
- 2021-05-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
YZ6-14283-25958
Child or adolescent in my care · · 2022-06-26
Timeline
-
2021-04-08
Dose 1 — Moderna
-
2021-05-06
Dose 2 — Moderna
-
2021-05-07
Registered in v-safe
-
2021-05-07
Survey response — days 1–6 daily, dose 2MedDRA: Chest discomfort — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Chest discomfort when I inhaleMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · DiarrheaAdult check-in
- 2021-05-10
-
2021-05-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-12
-
2021-06-19
Survey response — day 42, dose 2MedDRA: Chills, Pyrexia — Feeling: GoodFree text: I notice I have the chills coming and going very briefly which began with the chills and fever of my second shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-05
-
2021-11-04
Survey response — 6 months, dose 2MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2021-11-04
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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-05
-
2021-12-27
Dose 3 — Moderna
- 2022-06-27
-
2022-09-12
Dose 4 — Pfizer-BioNTech
- 2022-12-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna | |
| 2 | 2021-05-06 | Moderna | |
| 3 | 2021-12-27 | Moderna | No |
| 4 | 2022-09-12 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-04 | Unsuccessful |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Chest discomfort when I inhale
Release 9 — day 42, dose 2
Symptoms: I notice I have the chills coming and going very briefly which began with the chills and fever of my second shot.
Release 10 — 6 months, dose 2
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 | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release