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FW8-80002-86999

3 vaccinations 1 coded response 17 check-ins 1 free-text entry 1 call case
Sex
Female
Age at first dose
36-40
ZIP prefix
217 / MD
Registered
2021-05-17
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino
Registered dependents
BNL-35108-98214 Child or adolescent in my care · Female · 2022-06-14

Timeline

  1. 2021-05-17
    Registered in v-safe
  2. 2021-05-17
    Dose 1 — Moderna
  3. 2021-05-17
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-05-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-05-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-05-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-05-26
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-05-31
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-06-09
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-06-14
    Dose 2 — Moderna
  11. 2021-06-21
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  12. 2021-06-28
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-07-05
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-07-14
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-07-21
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-07-28
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-09-13
    Survey response — 3 months, dose 2
    MedDRA: Decreased appetite, Pain, Pyrexia — 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 visit
    Free text: Fever over 101. Body aches. Lots of appetite.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2021-09-13
    Report sent to call center — 3 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
    1 call case(s)
  19. 2021-09-16
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  20. 2021-12-13
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-12-30
    Dose 3 — Moderna
  22. 2022-06-14
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2022-06-30
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-05-17Moderna
22021-06-14Moderna No
32021-12-30Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-09-13 Successful
2021-09-16
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 9 — 3 months, dose 2

2021-09-13

Symptoms: Fever over 101. Body aches. Lots of appetite.

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
SDDecreased appetite · · ✓
SDPain · · ✓
SDPyrexia · · ✓

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

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