KLA-28753-40876
1 vaccination
2 coded responses
15 check-ins
2 free-text entries
0 call cases
- Sex
- —
- Age at first dose
- 16-20
- ZIP prefix
- 636 / MO
- Registered
- 2021-05-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-03
Registered in v-safe
-
2021-05-03
Dose 1 — Moderna
-
2021-05-03
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-05-04
Survey response — days 1–6 daily, dose 1MedDRA: Peripheral vascular disorder, Skin discolouration — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Poor circulation to lower extremeties including blueish discolorationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-05-06
-
2021-05-07
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-05-09
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-06-03
- 2021-06-09
- 2021-08-02
- 2021-11-01
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2022-05-05
Survey response — 12 months, dose 1MedDRA: Abortion spontaneous — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Miscarriage at ~5 weeks gestationMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-03 | Moderna |
Free text
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): Poor circulation to lower extremeties including blueish discoloration
Release 11 — 12 months, dose 1
Symptoms: Miscarriage at ~5 weeks gestation
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 | Peripheral vascular disorder | ✓ | ✓ | ✓ |
| SRO | Skin discolouration | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release