JSH-31211-01109
2 vaccinations
1 coded response
1 check-in
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 503 / IA
- Registered
- 2021-06-11
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-02-08
Dose 1 — Moderna
-
2021-03-12
Dose 2 — Moderna
-
2021-06-11
Registered in v-safe
-
2021-06-11
Survey response — 3 months, dose 2MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Miscarriage at 16 weeks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-11
Report sent to call center — 3 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 pr1 call case(s)
- 2021-06-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna | |
| 2 | 2021-03-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-11 | Unsuccessful |
Free text
Release 9 — 3 months, dose 2
Symptoms: Miscarriage at 16 weeks.
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 | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release