RKM-10860-12197
2 vaccinations
3 coded responses
13 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 611 / IL
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
-
2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
-
2021-02-04
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesFree text: Pain on leftvside upper body, head through shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-04-14
-
2021-06-02
Survey response — 3 months, dose 2MedDRA: Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cancer diagnosisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-02
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-14
Call successfulParticipant prefers to complete VAERS report online
- 2021-09-03
-
2022-03-06
Survey response — 12 months, dose 2MedDRA: Adverse reaction, Breast cancer stage IV — 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 · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Diagnosed breast cancer stage iv. Found with symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-03-06
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 prOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2022-03-09
- 2022-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Pain on leftvside upper body, head through shoulder
Release 8 — 3 months, dose 2
Symptoms: Cancer diagnosis
Release 11 — 12 months, dose 2
Symptoms: Diagnosed breast cancer stage iv. Found with 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 | Adverse reaction | · | · | ✓ |
| SD | Breast cancer stage IV | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release