UTR-11977-64055
2 vaccinations
3 coded responses
7 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 631 / MO
- Registered
- 2021-05-03
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Dose 1 — Moderna
-
2021-04-12
Dose 2 — Moderna
-
2021-05-03
Registered in v-safe
-
2021-05-03
Survey response — day 21, dose 2MedDRA: Chest pain, Dyspnoea, Nausea, Pruritus — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Chest pains, labored breathing, itchy nose, nauseaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-03
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-07-12
-
2021-10-11
Survey response — 6 months, dose 2MedDRA: Seborrhoeic dermatitis, Systemic lupus erythematosus — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Lupus diagnosis, seborrheic dermatitisMedDRA releases: 2024-11 · check-in free text available
-
2021-10-11
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2021-10-13
- 2021-10-13
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2022-04-12
Survey response — 12 months, dose 2MedDRA: Systemic lupus erythematosus — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Lupus diagnosisMedDRA releases: 2024-11 · check-in free text available
-
2022-04-12
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Moderna | |
| 2 | 2021-04-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-03 | Unsuccessful | |
| 2021-10-11 | Unsuccessful | |
| 2022-04-12 | Unsuccessful |
Free text
Release 8 — day 21, dose 2
Symptoms: Chest pains, labored breathing, itchy nose, nausea
Release 10 — 6 months, dose 2
Symptoms: Lupus diagnosis, seborrheic dermatitis
Release 11 — 12 months, dose 2
Symptoms: Lupus diagnosis
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Seborrhoeic dermatitis | · | · | ✓ |
| SD | Systemic lupus erythematosus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release