QDT-13306-37158
1 vaccination
3 coded responses
10 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 926 / CA
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Nausea · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
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2021-01-18
Report sent to call center — days 1–6 daily, 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)
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2021-01-19
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-29
- 2021-02-13
- 2021-02-19
- 2021-02-26
- 2021-03-19
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2022-01-15
Survey response — 12 months, dose 1MedDRA: Abortion spontaneous, Uterine dilation and curettage — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Miscarriage · Healthcare visit (other): Surgery (D&C)MedDRA releases: 2024-11 · check-in free text available
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2022-01-15
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-01-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-17 | Unsuccessful | |
| 2021-01-18 | Successful | Reported to VAERS voluntarily prior to GDIT contact |
| 2022-01-15 | Successful 2022-01-17 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness
Systemic reaction (other): Dizziness
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 | Uterine dilation and curettage | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release