UXW-26183-73196
1 vaccination
2 coded responses
3 check-ins
2 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 978 / OR
- Registered
- 2021-09-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-17
Dose 1 — Moderna
-
2021-09-25
Registered in v-safe
-
2021-09-25
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-09-25
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-09-28
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-01
Survey response — day 14, dose 1MedDRA: Discomfort, Hypoaesthesia, Injection site urticaria, Paraesthesia, Rash, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: A rash and hives came back on my arm around the injection site, spread down to my fingers. It goes numb and tingly from my shoulder to my fingers and is uncomfortableMedDRA releases: 2024-11 · check-in free text available
-
2021-10-01
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-10-08
Survey response — day 21, dose 1MedDRA: Blood pressure abnormal, Injection site rash, Liver disorder, Premature delivery — 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: Ended up delivering my baby 6 weeks early with liver and blood pressure issues, still have rash at injection siteMedDRA releases: 2024-11 · check-in free text available
-
2021-10-08
Report sent to call center — day 21, dose 1Be 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)
- 2021-10-12
-
2021-10-15
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-25 | Successful 2021-09-28 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-10-01 | Successful | Does not wish to fill out VAERS report |
| 2021-10-08 | Successful 2021-10-15 |
Does not wish to fill out VAERS report |
Free text
Release 9 — day 14, dose 1
Symptoms: A rash and hives came back on my arm around the injection site, spread down to my fingers. It goes numb and tingly from my shoulder to my fingers and is uncomfortable
Release 10 — day 21, dose 1
Symptoms: Ended up delivering my baby 6 weeks early with liver and blood pressure issues, still have rash at injection site
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 | Blood pressure abnormal | · | · | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Injection site rash | · | · | ✓ |
| SD | Injection site urticaria | · | · | ✓ |
| SD | Liver disorder | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Premature delivery | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release