J56-21953-93785
3 vaccinations
2 coded responses
10 check-ins
2 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 152 / PA
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
-
2021-01-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, VomitingAdult check-in
-
2021-01-07
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-07
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Swelling · Chills, Headache, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-01-08
- 2021-01-09
-
2021-01-26
Survey response — day 21, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Tested positive for COVIDMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Dose 2 — Moderna
-
2021-07-06
Survey response — 6 months, dose 1MedDRA: Lung opacity, Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Round glass opacity in lungs · Healthcare visit (other): Appointment with PCPMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-06
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-08
Call successfulCompleted over the phone
-
2021-11-16
Dose 3 — Moderna
-
2021-11-16
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-18
-
2021-11-19
Health check-in — days 1–6 daily, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-04 | Moderna | No |
| 3 | 2021-11-16 | Moderna | No |
Call center
3 call center cases
1 successful · 2 priority 2/3 (triaged and no follow up)
VAERS report filed, before or during a call: 1
Free text
Release 2 — day 21, dose 1
Symptoms: Tested positive for COVID
Release 9 — 6 months, dose 1
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 | Office visit | ✓ | · | ✓ |
| HCVO | Unevaluable event | ○ | ✓ | ○ |
| SD | Lung opacity | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release