M36-10285-78233
3 vaccinations
1 coded response
13 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 838 / ID
- Registered
- 2021-12-27
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Dose 1 — Moderna
-
2021-02-15
Dose 2 — Moderna
-
2021-12-27
Registered in v-safe
-
2021-12-27
Dose 3 — Moderna
-
2021-12-27
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-12-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal painAdult check-in
- 2021-12-29
- 2021-12-30
- 2021-12-31
- 2022-01-02
-
2022-01-03
Health check-in — day 7, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-01-10
- 2022-01-19
- 2022-01-31
-
2022-02-09
Survey response — day 42, dose 3MedDRA: Office visit, Tachycardia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Tachycardia · Healthcare visit (other): OBGYNMedDRA releases: 2024-11 · check-in free text available
-
2022-02-09
Report sent to call center — day 42, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-02-10
- 2022-02-17
- 2022-06-30
- 2022-12-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | No |
| 2 | 2021-02-15 | Moderna | No |
| 3 | 2021-12-27 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 11 — day 42, dose 3
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 | · | · | ✓ |
| SD | Tachycardia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release