SL5-30104-42907
2 vaccinations
3 coded responses
15 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 804 / CO
- Registered
- 2021-05-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-15
Dose 1 — Moderna
-
2021-05-13
Registered in v-safe
-
2021-05-13
Dose 2 — Moderna
-
2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-19
- 2021-05-20
- 2021-05-29
- 2021-06-03
-
2021-06-11
Survey response — day 28, dose 2MedDRA: Abortion spontaneous — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I haven't had any symptoms but I did have a miscarriage.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-11
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
- 2021-06-17
-
2021-06-21
Call successfulCompleted over the phone
- 2021-06-24
- 2021-08-14
-
2021-11-14
Survey response — 6 months, dose 2MedDRA: Dyspepsia, Nausea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nausea & indigestionMedDRA releases: 2024-11 · check-in free text available
-
2022-05-15
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis, Sinusitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sinus infection ColdMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-11 | Successful 2021-06-21 |
Completed over the phone |
Free text
Release 9 — day 28, dose 2
Symptoms: I haven't had any symptoms but I did have a miscarriage.
Release 10 — 6 months, dose 2
Symptoms: Nausea & indigestion
Release 11 — 12 months, dose 2
Symptoms: Sinus infection Cold
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Dyspepsia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release