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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

  1. 2021-06-02
    Dose 1 — Moderna
  2. 2021-06-11
    Registered in v-safe
  3. 2021-06-11
    Health check-in — day 7, dose 1
    Feeling: Poor · Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  4. 2021-06-16
    Survey response — day 14, dose 1
    MedDRA: Diarrhoea, Headache, Nasal congestion, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Runny nose, nasal congestion, sore throat, headache, diarrhea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-06-25
    Survey response — day 21, dose 1
    MedDRA: 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 visit
    Free text: Sinus infection, headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-06-25
    Report sent to call center — day 21, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  7. 2021-06-30
  8. 2021-07-01
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-07-05
    Dose 2 — Moderna
  10. 2021-07-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: 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 site
    Adult check-in
  11. 2021-07-06
  12. 2021-07-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness · Chills, Headache, Fatigue or tiredness, Diarrhea, Abdominal pain
    Adult check-in
  13. 2021-07-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-07-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · None
    Adult check-in
  15. 2021-07-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Heavy menstrual bleeding — Feeling: Fair
    Free 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
  16. 2021-07-12
    Health check-in — day 7, dose 2
    Feeling: Fair · None
    Adult check-in
  17. 2021-07-21
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-07-26
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2022-01-05
    Survey response — 6 months, dose 2
    MedDRA: 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, Hospitalization
    Free 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 pregnancy
    MedDRA releases: 2024-11 · check-in free text available
  20. 2022-01-05
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  21. 2022-01-06
  22. 2022-01-12
  23. 2022-07-05
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-06-02Moderna
22021-07-05Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-06-25 Unsuccessful
2022-01-05 Unsuccessful

Free text

Release 9 — day 14, dose 1

2021-06-16

Symptoms: Runny nose, nasal congestion, sore throat, headache, diarrhea

Release 9 — day 21, dose 1

2021-06-25

Symptoms: Sinus infection, headaches

Release 9 — days 1–6 daily, dose 2

2021-07-11

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

2022-01-05

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

FieldPreferred term2021-092023-042024-11
HCVOEctopic pregnancy · · ✓
HCVOSurgery · · ✓
HCVOTubal rupture · · ✓
SDDiarrhoea ✓ ✓ ✓
SDEctopic pregnancy · · ✓
SDGiardiasis · · ✓
SDHeadache ✓ ✓ ✓
SDMalaise · · ✓
SDNasal congestion ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSinusitis ✓ ✓ ✓
SROHeavy menstrual bleeding ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release