LK3-30802-68438
3 vaccinations
5 coded responses
29 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 068 / CT
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-02
Dose 1 — Moderna
-
2021-04-02
Survey response — day 0, dose 1MedDRA: Flatulence — Feeling: Fair · Site: PainFree text: GasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-05
- 2021-04-07
- 2021-04-16
- 2021-04-26
-
2021-04-30
Dose 2 — Moderna
-
2021-04-30
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-05-01
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Nausea, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-05-03
- 2021-05-04
- 2021-05-06
- 2021-05-14
- 2021-05-30
- 2021-06-11
-
2021-07-30
Survey response — 3 months, dose 2MedDRA: Cough, Oropharyngeal pain, Pyrexia, Rash, Respiratory tract congestion — Feeling: GoodFree text: Rash on breast that appeared on 4/30 on day of 2nd Moderna shot. Rash again appeared on 6/30 when I had a sore throat, fever, dry cough and congestion.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-10-29
-
2021-11-03
Dose 3 — Pfizer-BioNTech
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Abortion spontaneous — Feeling: Poor · Fever · Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Miscarried todayMedDRA releases: 2024-11 · check-in free text available
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2021-11-07
Report sent to call center — days 1–6 daily, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-11-08
- 2021-11-09
- 2021-11-09
- 2021-11-11
-
2021-11-17
Survey response — day 14, dose 3MedDRA: Abortion spontaneous — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-11-18
- 2021-12-01
- 2021-12-08
- 2022-11-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | |
| 2 | 2021-04-30 | Moderna | |
| 3 | 2021-11-03 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-07 | Unsuccessful | |
| 2021-11-17 | Unsuccessful |
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Gas
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Dizziness
Release 9 — 3 months, dose 2
Symptoms: Rash on breast that appeared on 4/30 on day of 2nd Moderna shot. Rash again appeared on 6/30 when I had a sore throat, fever, dry cough and congestion.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Miscarried today
Release 10 — day 14, dose 3
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 |
|---|---|---|---|---|
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Rash | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SRO | Abortion spontaneous | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release