JA2-50476-20713
4 vaccinations
3 coded responses
34 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 070 / NJ
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
QWD-30407-50438
Child or adolescent in my care · Female · 2022-09-12
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
-
2021-04-13
Dose 2 — Moderna
- 2021-04-13
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Presyncope — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Dizzyness / near faintingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: Good · Site: PainFree text: NightsweatsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-22
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-13
- 2021-10-12
-
2021-11-24
Dose 3 — Pfizer-BioNTech
- 2022-04-13
-
2022-09-09
Dose 4 — Pfizer-BioNTech
- 2022-09-12
- 2022-09-16
- 2022-09-23
-
2022-10-08
Survey response — day 28, dose 4MedDRA: Abortion spontaneous — 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 visitFree text: I had a miscarriageMedDRA releases: 2024-11 · check-in free text available
-
2022-10-08
Report sent to call center — day 28, dose 4Be 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 · 1 call case(s)
- 2022-10-11
- 2022-10-16
- 2022-10-21
- 2022-12-09
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-11-24 | Pfizer-BioNTech | No |
| 4 | 2022-09-09 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-08 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Dizzyness / near fainting
Systemic reaction (other): Nightsweats
Release 12 — day 28, dose 4
Symptoms: I had a miscarriage
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 | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Presyncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release