M9J-18252-94162
2 vaccinations
2 coded responses
6 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 146 / NY
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-26
Dose 1 — Moderna
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 2 — Moderna
- 2021-01-23
-
2021-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: Loss of appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-27
- 2021-07-24
-
2022-01-23
Survey response — 12 months, dose 2MedDRA: Office visit, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pregnant · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-01-23
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-01-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-26 | Moderna | |
| 2 | 2021-01-23 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Loss of appetite
Release 11 — 12 months, dose 2
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 | Pregnancy | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release