FMA-15843-13098
3 vaccinations
2 coded responses
15 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 984 / WA
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
-
2021-01-26
Dose 1 — Moderna
- 2021-01-26
-
2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-04
- 2021-02-11
-
2021-03-02
Dose 2 — Moderna
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-03-05
- 2021-08-31
-
2021-12-30
Dose 3 — Pfizer-BioNTechCo-administered: Flu
-
2021-12-31
Survey response — days 1–6 daily, dose 3MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: LightheadedMedDRA releases: 2024-11 · check-in free text available
- 2022-01-02
- 2022-01-08
- 2022-01-27
- 2022-02-10
- 2022-04-02
-
2022-07-02
Survey response — 6 months, dose 3MedDRA: Stillbirth — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Experienced a stillbirthMedDRA releases: 2024-11 · check-in free text available
-
2022-07-02
Report sent to call center — 6 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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-07-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-12-30 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-02 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Lightheaded
Release 12 — 6 months, dose 3
Symptoms: Experienced a stillbirth
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 | Stillbirth | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release