U69-30520-46189
4 vaccinations
2 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 998 / AK
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Dose 1 — Moderna
-
2021-03-05
Dose 2 — Moderna
-
2021-03-10
Registered in v-safe
-
2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Pyrexia — Feeling: GoodFree text: Late responder here, had a fever+chills first 24 hours then no symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-12
- 2021-03-26
- 2021-04-02
- 2021-06-04
- 2021-09-03
-
2021-11-25
Dose 3 — Moderna
-
2022-03-05
Survey response — 12 months, dose 2MedDRA: Abortion spontaneous — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2022-03-05
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-09-24
Dose 4 — ModernaCo-administered: Flu
- 2022-09-25
- 2022-09-27
- 2022-09-28
- 2022-10-01
- 2022-10-08
- 2022-10-17
- 2022-11-05
- 2022-12-24
- 2023-03-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-05 | Moderna | |
| 3 | 2021-11-25 | Moderna | No |
| 4 | 2022-09-24 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-05 | Successful 2022-03-10 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Late responder here, had a fever+chills first 24 hours then no symptoms
Release 11 — 12 months, dose 2
Symptoms: Miscarriage
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 | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release