FJN-22421-32462
3 vaccinations
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 488 / MI
- Registered
- 2021-10-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-04-15
Dose 2 — Moderna
-
2021-10-24
Dose 3 — Moderna
-
2021-10-25
Registered in v-safe
-
2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tirednessAdult check-in
- 2021-10-26
- 2021-10-27
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-07
- 2021-11-14
- 2021-11-21
-
2021-11-28
Survey response — day 35, dose 3MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend schoolFree text: Cold. Negative covid test.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-06
-
2022-01-23
Survey response — 3 months, dose 3MedDRA: Breast mass, Mammogram abnormal, Ultrasound breast abnormal — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Lump in breast. Suspicious mammogram and ultrasound. Biopsy scheduled.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-23
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-01
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | No |
| 2 | 2021-04-15 | Moderna | No |
| 3 | 2021-10-24 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 35, dose 3
Symptoms: Cold. Negative covid test.
Release 11 — 3 months, dose 3
Symptoms: Lump in breast. Suspicious mammogram and ultrasound. Biopsy scheduled.
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 | Breast mass | · | · | ✓ |
| SD | Mammogram abnormal | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Ultrasound breast abnormal | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release