UVS-20959-73853
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 921 / CA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
-
2021-02-04
Survey response — day 0, dose 1MedDRA: Confusional state, Office visit — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Confusion · Healthcare visit (other): I saw a doctor at the vaccination clinicMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Report sent to call center — day 0, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-10
-
2021-02-11
Survey response — day 7, dose 1MedDRA: Photopsia — Feeling: GoodFree text: I have been seeing stars (small flashes of light) about once a day since I got the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-25
-
2021-03-04
Survey response — day 28, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: My vaccinated arm became sore for a couple days. Feb27th-Mar1st.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
-
2021-03-14
Dose 2 — Moderna
- 2021-03-20
- 2021-03-21
- 2021-03-30
- 2021-04-05
- 2021-04-11
- 2021-04-19
- 2021-09-12
- 2022-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-14 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-04 | Unsuccessful |
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Confusion
Healthcare visit (other): I saw a doctor at the vaccination clinic
Release 4 — day 7, dose 1
Systemic reaction (other): I have been seeing stars (small flashes of light) about once a day since I got the vaccine.
Release 5 — day 28, dose 1
Symptoms: My vaccinated arm became sore for a couple days. Feb27th-Mar1st.
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 | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Photopsia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release