LD4-33836-54321
3 vaccinations
1 coded response
42 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 920 / CA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
TCV-29540-65858
Child or adolescent in my care · Male · 2021-11-17
53W-14953-15526
Child or adolescent in my care · Female · 2022-06-27
5FF-27299-96893
Child or adolescent in my care · Male · 2022-06-27
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-26
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-06-03
- 2021-09-02
-
2021-11-01
Dose 3 — Moderna
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2022-01-31
-
2022-05-02
Survey response — 6 months, dose 3MedDRA: Abortion spontaneous — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have had two miscarriages... one in December of 2021 at 6 weeks pregnant and one in March of 2022 at 9 weeks pregnant. I have 3 living children ages 5, 3, and 1. These are the first miscarriages I have ever had.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-02
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-03
Call successfulCompleted over the phone
- 2022-11-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-02 | Successful 2022-05-03 |
Completed over the phone |
Free text
Release 11 — 6 months, dose 3
Symptoms: I have had two miscarriages... one in December of 2021 at 6 weeks pregnant and one in March of 2022 at 9 weeks pregnant. I have 3 living children ages 5, 3, and 1. These are the first miscarriages I have ever had.
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