E89-15662-20175
3 vaccinations
6 coded responses
29 check-ins
6 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 191 / PA
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, NauseaAdult check-in
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
- 2021-03-02
-
2021-03-09
Survey response — day 28, dose 2MedDRA: Migraine with aura — Feeling: Good · Be unable to do your normal daily activitiesFree text: Migraine with aura 3/8MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — day 35, dose 2MedDRA: Migraine with aura — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Migraine with auraMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-23
- 2021-05-11
-
2021-08-10
Survey response — 6 months, dose 2MedDRA: Arthralgia, Migraine, Neck pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Migraine with neck pain radiating to shoulderMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-14
Dose 3 — Moderna
-
2021-12-21
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-02-09
Survey response — 12 months, dose 2MedDRA: Breast tenderness, Menstruation delayed — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Left breast tenderness (same side as injection), delayed menstruation - scheduled to see OBGYN 2/22MedDRA releases: 2024-11 · check-in free text available
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2022-02-09
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-11
Call successfulDoes not wish to fill out VAERS report
- 2022-02-19
-
2022-05-15
Survey response — 6 months, dose 3MedDRA: Menstruation irregular — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Irregular periodMedDRA releases: 2024-11 · check-in free text available
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2022-05-15
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-16
- 2022-05-16
- 2022-05-16
- 2022-05-19
- 2022-05-19
- 2022-05-19
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2022-11-14
Survey response — 12 months, dose 3MedDRA: Abortion spontaneous, Breast tenderness — 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 · Outpatient clinic or urgent care clinic visitFree text: Left breast tenderness MiscarriageMedDRA releases: 2024-11 · check-in free text available
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2022-11-14
Report sent to call center — 12 months, dose 3Be 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 · 1 call case(s)
- 2022-11-15
- 2022-11-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-16 | Successful 2021-12-21 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-02-09 | Successful 2022-02-11 |
Does not wish to fill out VAERS report |
| 2022-05-15 | Unsuccessful | |
| 2022-11-14 | Unsuccessful |
Free text
Release 5 — day 28, dose 2
Symptoms: Migraine with aura 3/8
Release 5 — day 35, dose 2
Symptoms: Migraine with aura
Release 9 — 6 months, dose 2
Symptoms: Migraine with neck pain radiating to shoulder
Release 11 — 12 months, dose 2
Symptoms: Left breast tenderness (same side as injection), delayed menstruation - scheduled to see OBGYN 2/22
Release 11 — 6 months, dose 3
Symptoms: Irregular period
Release 12 — 12 months, dose 3
Symptoms: Left breast tenderness 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 | Arthralgia | ✓ | · | ✓ |
| SD | Breast tenderness | · | · | ✓ |
| SD | Menstruation delayed | · | · | ✓ |
| SD | Menstruation irregular | · | · | ✓ |
| SD | Migraine | ✓ | · | ✓ |
| SD | Migraine with aura | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release