V29-22631-70367
3 vaccinations
5 coded responses
34 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 926 / CA
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
-
2021-01-25
Dose 1 — Moderna
- 2021-01-25
-
2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-11
- 2021-02-16
- 2021-02-22
-
2021-03-01
Dose 2 — Moderna
-
2021-03-01
Survey response — day 0, dose 2MedDRA: Hypersensitivity — Feeling: Good · Site: Pain · HeadacheFree text: AllergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
-
2021-03-08
Survey response — day 7, dose 2MedDRA: Pre-existing disease — Feeling: Good · Muscle or body achesFree text: AllergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-23
- 2021-03-31
- 2021-04-06
- 2021-04-12
- 2021-06-01
- 2021-09-01
-
2021-12-11
Dose 3 — Moderna
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
-
2021-12-30
Survey response — day 14, dose 3MedDRA: Cough, Fatigue, Myalgia, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cough, runny nose, sore throat, fatigue, muscle painMedDRA releases: 2024-11 · check-in free text available
-
2022-01-01
Survey response — day 21, dose 3MedDRA: Ageusia, Anosmia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Lost of taste and smellMedDRA releases: 2024-11 · check-in free text available
- 2022-01-15
- 2022-01-24
- 2022-03-14
- 2022-06-13
-
2022-12-13
Survey response — 12 months, dose 3MedDRA: Erythema, Rash, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Occasional hives, rashes, redness, and bumps appear all over my body, lasting for 10 minutes, and go away.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-13
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-14
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-03-01 | Moderna | |
| 3 | 2021-12-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-13 | Successful 2022-12-14 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Allergies
Release 5 — day 7, dose 2
Systemic reaction (other): Allergies
Release 10 — day 14, dose 3
Symptoms: Cough, runny nose, sore throat, fatigue, muscle pain
Release 10 — day 21, dose 3
Symptoms: Lost of taste and smell
Release 12 — 12 months, dose 3
Symptoms: Occasional hives, rashes, redness, and bumps appear all over my body, lasting for 10 minutes, and go away.
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 | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release