R5P-21355-83116
3 vaccinations
3 coded responses
22 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 926 / CA
- Registered
- 2021-03-20
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-20
Registered in v-safe
-
2021-03-20
Dose 1 — Moderna
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-21
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-03-22
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
-
2021-04-03
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: GoodFree text: I developed a rash with itchiness around the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-17
-
2021-04-23
Dose 2 — Moderna
-
2021-04-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-26
- 2021-04-27
-
2021-04-30
Survey response — day 7, dose 2MedDRA: Abortion spontaneous — Feeling: Poor · Headache, Abdominal pain · Be unable to workFree text: Experiencing a miscarriageMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-09
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-07-27
-
2021-10-24
Survey response — 6 months, dose 2MedDRA: Influenza like illness, Viral infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Flu like virusMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Dose 3 — Moderna
- 2022-04-23
- 2022-11-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-11-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-21 | priority 2/3 |
Free text
Release 6 — day 14, dose 1
Symptoms: I developed a rash with itchiness around the injection site.
Release 8 — day 7, dose 2
Systemic reaction (other): Experiencing a miscarriage
Release 10 — 6 months, dose 2
Symptoms: Flu like virus
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 | Influenza like illness | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Abortion spontaneous | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release