USA-19167-26927
2 vaccinations
3 coded responses
6 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 280 / NC
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Registered in v-safe
-
2020-12-29
Dose 1 — Moderna
- 2020-12-29
- 2020-12-29
- 2020-12-30
-
2021-01-27
Dose 2 — Moderna
-
2021-01-27
Survey response — day 0, dose 2MedDRA: Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to workFree text: Fainted a few times.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to workFree text: FaintingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Joint pains · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2022-01-27
Survey response — 12 months, dose 2MedDRA: Abortion spontaneous, Ectopic pregnancy, Office visit, Seizure — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Symptoms: Seizures Miscarriages Ectopic pregnancies · Healthcare visit (other): SpecialistMedDRA releases: 2024-11 · check-in free text available
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2022-01-27
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-01-28
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2020-12-29 | priority 2/3 | |
| 2022-01-27 | Successful 2022-01-28 |
Participant prefers to complete VAERS report online |
Free text
Release 2 — day 0, dose 2
Systemic reaction (other): Fainted a few times.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Fainting
Release 11 — 12 months, dose 2
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Ectopic pregnancy | · | · | ✓ |
| SD | Seizure | · | · | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release