J5N-28105-40300
3 vaccinations
2 coded responses
27 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 017 / MA
- Registered
- 2021-03-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Registered in v-safe
-
2021-03-25
Dose 1 — Moderna
- 2021-03-25
-
2021-03-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
-
2021-04-23
Dose 2 — Moderna
- 2021-04-23
-
2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Light headed but it is mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-04-27
- 2021-04-28
- 2021-04-29
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-23
- 2021-05-28
- 2021-06-04
- 2021-07-25
- 2021-10-22
-
2021-12-02
Dose 3 — Moderna
- 2022-04-23
- 2022-06-02
-
2022-12-02
Survey response — 12 months, dose 3MedDRA: Biochemical pregnancy, Urticaria — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I have chronic hives and had 3 chemical pregnanciesMedDRA releases: 2024-11 · check-in free text available
-
2022-12-02
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-05
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-02 | Successful 2022-12-05 |
Participant prefers to complete VAERS report online |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Light headed but it is mild
Release 12 — 12 months, dose 3
Symptoms: I have chronic hives and had 3 chemical pregnancies
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 | Biochemical pregnancy | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release