PAQ-11494-32539
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 606 / IL
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-05
- 2021-01-06
-
2021-01-07
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-07
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-11
- 2021-01-14
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Cough, Drainage, Fatigue, Headache, Influenza like illness, Pain, Rhinorrhoea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Flu symptoms: cough, runny nose, drainage, body aches, fatigue, headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-26
-
2021-02-02
Survey response — day 28, dose 1MedDRA: Bronchitis, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Bronchitis and sinus infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-09
-
2021-02-12
Dose 2 — Moderna
-
2021-02-12
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-13
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-05-13
Call successfulDoes not wish to fill out VAERS report
- 2021-05-14
- 2021-08-13
-
2022-02-12
Survey response — 12 months, dose 2MedDRA: COVID-19, Pregnancy — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: COVID Pregnancy symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-02-12
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
4 call center cases
3 successful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 2 — day 14, dose 1
Symptoms: Flu symptoms: cough, runny nose, drainage, body aches, fatigue, headaches
Release 3 — day 28, dose 1
Symptoms: Bronchitis and sinus infection
Release 11 — 12 months, dose 2
Symptoms: COVID Pregnancy symptoms
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 | Bronchitis | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Drainage | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza like illness | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release