KUP-23938-01766
4 vaccinations
4 coded responses
32 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 506 / IA
- Registered
- 2020-12-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-23
Registered in v-safe
-
2020-12-23
Dose 1 — Moderna
-
2020-12-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2021-01-06
- 2021-01-13
-
2021-01-18
Dose 2 — Moderna
-
2021-01-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
-
2021-02-01
Survey response — day 14, dose 2MedDRA: Cholelithiasis, Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Gallstones required laparoscopic cholecystectomy on 1/28/21. · Healthcare visit (other): surgeryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-01
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-04-19
-
2021-06-16
Call successfulDoes not wish to fill out VAERS report
- 2021-07-19
-
2021-10-28
Dose 3 — Moderna
- 2021-11-26
-
2021-12-02
Survey response — day 35, dose 3MedDRA: SARS-CoV-2 test negative, Viral upper respiratory tract infection — Feeling: FairFree text: Viral upper respiratory, COVID negative.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-09
- 2022-01-27
- 2022-04-28
-
2022-10-06
Dose 4 — Pfizer-BioNTech
-
2022-10-12
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Axillary lymphadenopathyMedDRA releases: 2024-11 · check-in free text available
- 2022-10-13
- 2022-10-20
- 2022-10-29
- 2022-11-03
-
2022-11-10
Survey response — day 35, dose 4MedDRA: Abortion spontaneous — Feeling: Good · Be unable to work or attend schoolFree text: Miscarriage.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-17
- 2023-01-05
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-18 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-10-06 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-01 | Successful 2021-06-16 |
Does not wish to fill out VAERS report |
Free text
Release 3 — day 14, dose 2
Symptoms: Gallstones required laparoscopic cholecystectomy on 1/28/21.
Healthcare visit (other): surgery
Release 10 — day 35, dose 3
Symptoms: Viral upper respiratory, COVID negative.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Axillary lymphadenopathy
Release 12 — day 35, dose 4
Symptoms: 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 |
|---|---|---|---|---|
| HCVO | Surgery | ✓ | ✓ | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Cholelithiasis | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral upper respiratory tract infection | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release