L9K-47273-34032
1 vaccination
2 coded responses
14 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 287 / NC
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-03-01
- 2021-03-07
-
2021-03-13
Survey response — day 28, dose 1MedDRA: Gastroenteritis viral — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Stomach bug. Grand babes had it last week and I watched them.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-08-14
-
2022-02-15
Survey response — 12 months, dose 1MedDRA: Eye infection, Office visit, Unevaluable event, Uterine cyst, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Cyst in uterus and eye infections · Healthcare visit (other): Out patient dnc and eye dropsMedDRA releases: 2024-11 · check-in free text available
-
2022-02-15
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-02-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-15 | Successful 2022-02-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 5 — day 28, dose 1
Symptoms: Stomach bug. Grand babes had it last week and I watched them.
Release 11 — 12 months, dose 1
Symptoms: Cyst in uterus and eye infections
Healthcare visit (other): Out patient dnc and eye drops
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 | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| HCVO | Uterine dilation and curettage | · | · | ✓ |
| SD | Eye infection | · | · | ✓ |
| SD | Gastroenteritis viral | ✓ | ✓ | ✓ |
| SD | Uterine cyst | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release