PUW-33046-08281
1 vaccination
1 coded response
11 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 054 / VT
- Registered
- 2020-12-27
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-27
Registered in v-safe
-
2020-12-27
Dose 1 — Moderna
- 2020-12-27
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-11
- 2021-01-20
- 2021-06-27
-
2021-12-27
Survey response — 12 months, dose 1MedDRA: Abortion spontaneous, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Miscarriage at 17 weeks · Healthcare visit (other): D and EMedDRA releases: 2024-11 · check-in free text available
-
2021-12-27
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-28
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-27 | Successful 2021-12-28 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — 12 months, dose 1
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 | Unevaluable event | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release