H29-30019-87594
4 vaccinations
1 coded response
40 check-ins
0 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 917 / CA
- Registered
- 2021-03-23
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
BJW-60370-59679
Child or adolescent in my care · Female · 2022-06-28
WGQ-22225-34527
Child or adolescent in my care · Male · 2022-07-14
Timeline
-
2021-03-23
Registered in v-safe
-
2021-03-23
Dose 1 — Moderna
- 2021-03-23
-
2021-03-24
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-24
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-04-06
- 2021-04-13
-
2021-04-20
Dose 2 — Moderna
- 2021-04-20
-
2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-19
-
2021-12-21
Dose 3 — Moderna
- 2022-04-20
- 2022-06-21
-
2022-09-22
Dose 4 — Moderna
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-12-22
-
2023-03-25
Survey response — 6 months, dose 4MedDRA: Cough, Nasal congestion — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-12-21 | Moderna | No |
| 4 | 2022-09-22 | Moderna | No |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
None.
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 | Cough | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release