KCA-26462-21409
2 vaccinations
7 coded responses
22 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 034 / NH
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
- 2021-02-04
- 2021-02-05
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Injection site oedema — Feeling: Good · Site: PainFree text: Lump at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Injection site mass — Feeling: Good · Site: PainFree text: Lump at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-10
-
2021-02-17
Survey response — day 14, dose 1MedDRA: Chills, Pyrexia — Feeling: FairFree text: Intermittent fever, chillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
-
2021-03-06
Dose 2 — Moderna
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Injection site mass — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to workFree text: Lump at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Injection site mass — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Lump at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, HeadacheAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-06-07
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2021-09-04
Survey response — 6 months, dose 2MedDRA: Headache, Oropharyngeal pain — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Headaches and sore throatMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-04
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-14
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2021-09-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-03-06
Survey response — 12 months, dose 2MedDRA: Pregnancy — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: PregnancyMedDRA releases: 2024-11 · check-in free text available
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2022-03-06
Report sent to call center — 12 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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-03-08
Call successfulDoes not wish to fill out VAERS report
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no date
Callback requested for05:00PM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-06 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Lump at injection site
Systemic reaction (other): Lump at injection site
Release 4 — day 14, dose 1
Symptoms: Intermittent fever, chills
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Lump at injection site
Systemic reaction (other): Lump at injection site
Release 9 — 6 months, dose 2
Symptoms: Headaches and sore throat
Release 11 — 12 months, dose 2
Symptoms: Pregnancy
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 | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Injection site mass | ✓ | ✓ | ✓ |
| SRO | Injection site oedema | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release