UQD-20648-01307
3 vaccinations
1 coded response
12 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 119 / NY
- Registered
- 2021-05-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Dose 1 — Moderna
-
2021-03-30
Dose 2 — Moderna
-
2021-05-15
Registered in v-safe
- 2021-05-15
- 2021-06-29
- 2021-09-28
-
2021-11-02
Dose 3 — Moderna
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend schoolAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-11
- 2021-11-16
-
2021-11-27
Survey response — day 21, dose 3MedDRA: Deep vein thrombosis, Thrombosis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Blood clots/DVTMedDRA releases: 2024-11 · check-in free text available
-
2021-11-27
Report sent to call center — day 21, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2021-11-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 10 — day 21, dose 3
Symptoms: Blood clots/DVT
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 | Deep vein thrombosis | · | · | ✓ |
| SD | Thrombosis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release