U4S-30168-19686
2 vaccinations
1 coded response
1 check-in
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 068 / CT
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-02-11
Dose 2 — Moderna
-
2021-03-19
Registered in v-safe
-
2021-03-19
Survey response — day 35, dose 2MedDRA: Anxiety, Insomnia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Difficulty sleeping, anxiousMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities1 call case(s)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
Release 5 — day 35, dose 2
Symptoms: Difficulty sleeping, anxious
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 | Anxiety | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release