HUD-33088-11782
2 vaccinations
1 coded response
10 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 675 / KS
- Registered
- 2021-09-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-03
Dose 1 — Moderna
-
2021-09-06
Registered in v-safe
-
2021-09-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-07
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, NauseaAdult check-in
- 2021-09-08
- 2021-09-10
- 2021-09-18
-
2021-10-01
Dose 2 — Moderna
-
2021-10-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-10-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-10-26
- 2021-11-18
-
2022-04-03
Survey response — 6 months, dose 2MedDRA: Abortion spontaneous, Premature separation of placenta — 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: I had a placental abruption and lost my baby.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Report sent to call center — 6 months, dose 2Be 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)
- 2022-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-03 | Moderna | No |
| 2 | 2021-10-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-03 | Unsuccessful |
Free text
Release 11 — 6 months, dose 2
Symptoms: I had a placental abruption and lost my baby.
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 | Abortion spontaneous | · | · | ✓ |
| SD | Premature separation of placenta | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release