F3B-14343-00446
3 vaccinations
5 coded responses
29 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 783 / TX
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-28
Dose 1 — Moderna
-
2020-12-30
Registered in v-safe
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-20
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-27
- 2021-01-28
- 2021-01-30
- 2021-01-31
- 2021-02-08
- 2021-02-15
- 2021-02-24
- 2021-03-08
- 2021-04-26
-
2021-07-26
Survey response — 6 months, dose 2MedDRA: Fatigue, Pyrexia, Respiratory tract congestion, Sinus headache, Sneezing — Feeling: Good · Be unable to work or attend schoolFree text: Fever, congestion, sinus headache, sneezing, fatigueMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-23
Dose 3 — Moderna
- 2021-10-23
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Eye irritation — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessFree text: Burning sensation in eyesMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-30
-
2021-11-06
Survey response — day 14, dose 3MedDRA: Brain fog, Disturbance in attention, Oropharyngeal pain — Feeling: GoodFree text: Sore throat ; lack of mental focus and clarityMedDRA releases: 2024-11 · check-in free text available
- 2021-11-13
- 2021-11-22
- 2021-12-04
-
2022-01-22
Survey response — 3 months, dose 3MedDRA: Adverse reaction, Menstruation delayed — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Delayed period ; ulcer symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-01-22
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-10-23
Survey response — 12 months, dose 3MedDRA: Cardiac disorder, SARS-CoV-2 test positive — Feeling: Good · 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: Tested positive for COVID-19, shortly after was dealing with post cardio symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-10-23
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-25
-
2022-11-09
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 9 — 6 months, dose 2
Symptoms: Fever, congestion, sinus headache, sneezing, fatigue
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Burning sensation in eyes
Release 10 — day 14, dose 3
Symptoms: Sore throat ; lack of mental focus and clarity
Release 11 — 3 months, dose 3
Symptoms: Delayed period ; ulcer symptoms
Release 12 — 12 months, dose 3
Symptoms: Tested positive for COVID-19, shortly after was dealing with post cardio symptoms
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 | Adverse reaction | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Menstruation delayed | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus headache | ✓ | · | ✓ |
| SD | Sneezing | ✓ | · | ✓ |
| SRO | Eye irritation | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release