U9F-63708-91900
4 vaccinations
4 coded responses
38 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 573 / SD
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-13
- 2021-01-20
-
2021-01-22
Dose 2 — Moderna
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-28
- 2021-03-05
-
2021-04-24
Survey response — 3 months, dose 2MedDRA: Diarrhoea, Gastroenteritis, Nausea, Vomiting — Feeling: Good · Be unable to workFree text: Gastroenteritis - nausea, vomiting, diarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-23
-
2021-11-12
Dose 3 — Moderna
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-26
-
2021-12-04
Survey response — day 21, dose 3MedDRA: Nasopharyngitis — Feeling: FairFree text: Bad cold, unrelated to the vaccineMedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Survey response — day 28, dose 3MedDRA: Nasopharyngitis, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Bad cold that turned into a sinus infectionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-13
-
2021-12-16
Call successfulDoes not wish to fill out VAERS report
- 2021-12-18
- 2021-12-24
- 2022-02-11
-
2022-05-13
Survey response — 6 months, dose 3MedDRA: Delivery — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Childbirth - delivered a healthy babyMedDRA releases: 2024-11 · check-in free text available
-
2022-05-13
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-05-17
- 2022-05-17
-
2022-05-18
Call successfulNot applicable - Accidental Reporting
-
2022-10-14
Dose 4 — ModernaCo-administered: Flu
- 2022-11-14
- 2022-11-14
- 2022-11-18
- 2022-11-25
- 2023-01-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-22 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-10-14 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 7 — 3 months, dose 2
Symptoms: Gastroenteritis - nausea, vomiting, diarrhea
Release 10 — day 21, dose 3
Symptoms: Bad cold, unrelated to the vaccine
Release 10 — day 28, dose 3
Symptoms: Bad cold that turned into a sinus infection
Release 11 — 6 months, dose 3
Symptoms: Childbirth - delivered a healthy baby
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 | Delivery | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Gastroenteritis | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release