V27-19137-85717
3 vaccinations
3 coded responses
39 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 641 / MO
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-29
- 2021-02-05
- 2021-02-12
-
2021-02-19
Dose 2 — Moderna
-
2021-02-19
Survey response — day 0, dose 2MedDRA: Dizziness — Feeling: Good · Site: Pain · NauseaFree text: LightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-04
-
2021-05-23
Survey response — 3 months, dose 2MedDRA: Dizziness — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Dizziness, crossed eyesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-23
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-20
-
2022-01-12
Dose 3 — Moderna
- 2022-01-12
-
2022-01-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-01-14
- 2022-01-15
- 2022-01-16
- 2022-01-17
- 2022-01-18
- 2022-01-19
-
2022-01-26
Survey response — day 14, dose 3MedDRA: Abdominal pain, Hospitalisation, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Abdominal pain, was admitted overnight for preterm labor rule out.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-01-28
Call successfulDoes not wish to fill out VAERS report
- 2022-02-02
- 2022-02-09
- 2022-02-16
- 2022-02-23
- 2022-04-13
- 2022-07-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2022-01-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-23 | Successful | Does not wish to fill out VAERS report |
| 2022-01-26 | Successful 2022-01-28 |
Does not wish to fill out VAERS report |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Lightheaded
Release 8 — 3 months, dose 2
Symptoms: Dizziness, crossed eyes
Release 11 — day 14, dose 3
Symptoms: Abdominal pain, was admitted overnight for preterm labor rule out.
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 | Abdominal pain | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release