HMJ-17623-97724
4 vaccinations
3 coded responses
23 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 770 / TX
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Dose 1 — Moderna
-
2021-01-13
Registered in v-safe
- 2021-01-15
- 2021-01-22
-
2021-01-27
Survey response — day 21, dose 1MedDRA: Cough, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cough - believe post nasal drip from allergies. I got tested and was COVID negative.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-03
Dose 2 — Moderna
- 2021-02-03
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
-
2021-02-17
Survey response — day 14, dose 2MedDRA: Ear discomfort, Hypersensitivity, Upper-airway cough syndrome — Feeling: GoodFree text: Ear fullness, post nasal drip- most likely allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
-
2021-04-14
Call successfulDoes not wish to fill out VAERS report
- 2021-05-05
- 2021-08-04
- 2022-02-03
-
2022-06-28
Dose 3 — Pfizer-BioNTech
-
2022-09-14
Dose 4 — Moderna
- 2022-10-20
- 2022-10-26
-
2022-12-14
Survey response — 3 months, dose 4MedDRA: SARS-CoV-2 test negative, Unevaluable event, Viral infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Something viral. Was Covid Neg on home test · Healthcare visit (other): Self prescribed antibioticsMedDRA releases: 2024-11 · check-in free text available
-
2022-12-14
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-12-15
-
2022-12-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2022-06-28 | Pfizer-BioNTech | No |
| 4 | 2022-09-14 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — day 21, dose 1
Symptoms: Cough - believe post nasal drip from allergies. I got tested and was COVID negative.
Release 4 — day 14, dose 2
Symptoms: Ear fullness, post nasal drip- most likely allergies
Release 12 — 3 months, dose 4
Symptoms: Something viral. Was Covid Neg on home test
Healthcare visit (other): Self prescribed antibiotics
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release