DVA-13058-21985
2 vaccinations
4 coded responses
14 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 669 / KS
- Registered
- 2021-06-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-02
Dose 1 — Moderna
-
2021-06-11
Registered in v-safe
-
2021-06-11
Health check-in — day 7, dose 1Feeling: Poor · Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-06-16
Survey response — day 14, dose 1MedDRA: Diarrhoea, Headache, Nasal congestion, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Runny nose, nasal congestion, sore throat, headache, diarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-25
Survey response — day 21, dose 1MedDRA: Headache, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection, headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-25
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-30
- 2021-07-01
-
2021-07-05
Dose 2 — Moderna
-
2021-07-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-07-06
-
2021-07-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · Chills, Headache, Fatigue or tiredness, Diarrhea, Abdominal painAdult check-in
- 2021-07-09
- 2021-07-10
-
2021-07-11
Survey response — days 1–6 daily, dose 2MedDRA: Heavy menstrual bleeding — Feeling: FairFree text: Started my period yesterday. Ive had an extremely heavy flow, when I typically only have a very light flow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-12
- 2021-07-21
- 2021-07-26
-
2022-01-05
Survey response — 6 months, dose 2MedDRA: Ectopic pregnancy, Giardiasis, Malaise, Nasopharyngitis, Surgery, Tubal rupture — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Symptoms: I had an ectopic pregnancy, then got giardia. I had to take several antibiotics to clear the giardia which caused joint pain and C diff. Currently having symptoms of either cold or Covid. · Healthcare visit (other): Surgery to remove ruptured tube after ectopic pregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-01-05
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 prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-01-06
- 2022-01-12
- 2022-07-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-02 | Moderna | |
| 2 | 2021-07-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-25 | Unsuccessful | |
| 2022-01-05 | Unsuccessful |
Free text
Release 9 — day 14, dose 1
Symptoms: Runny nose, nasal congestion, sore throat, headache, diarrhea
Release 9 — day 21, dose 1
Symptoms: Sinus infection, headaches
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Started my period yesterday. Ive had an extremely heavy flow, when I typically only have a very light flow.
Release 10 — 6 months, dose 2
Symptoms: I had an ectopic pregnancy, then got giardia. I had to take several antibiotics to clear the giardia which caused joint pain and C diff. Currently having symptoms of either cold or Covid.
Healthcare visit (other): Surgery to remove ruptured tube after ectopic pregnancy
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 |
|---|---|---|---|---|
| HCVO | Ectopic pregnancy | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Tubal rupture | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Ectopic pregnancy | · | · | ✓ |
| SD | Giardiasis | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release