VFS-31363-78472
1 vaccination
4 coded responses
15 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 670 / KS
- Registered
- 2021-09-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NMZ-37854-93458
Adult relative or friend · Male · 2021-09-17
Timeline
-
2021-09-17
Registered in v-safe
-
2021-09-17
Dose 1 — Moderna
-
2021-09-17
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Good · Site: PainFree text: Light HeadedMedDRA releases: 2024-11 · check-in free text available
-
2021-09-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · HeadacheAdult check-in
- 2021-09-19
- 2021-09-20
- 2021-09-21
- 2021-09-22
- 2021-09-23
- 2021-09-26
-
2021-10-01
Survey response — day 14, dose 1MedDRA: Injection site reaction, Rash erythematous, Rash papular — Feeling: GoodFree text: 9 days after 1st shot a red raised rash at injection site appeared on my armMedDRA releases: 2024-11 · check-in free text available
- 2021-10-08
-
2021-10-19
Survey response — day 28, dose 1MedDRA: Menstrual disorder — Feeling: GoodFree text: Menstrual cycle changed after receiving the vaccine.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-24
- 2021-12-17
-
2022-03-18
Survey response — 6 months, dose 1MedDRA: Abortion spontaneous — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Was pregnant and didn't know when I received my 2nd shot. Pregnancy ended in an early miscarriage.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-18
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-03-21
- 2022-09-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-18 | Unsuccessful |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): Light Headed
Release 9 — day 14, dose 1
Symptoms: 9 days after 1st shot a red raised rash at injection site appeared on my arm
Release 10 — day 28, dose 1
Symptoms: Menstrual cycle changed after receiving the vaccine.
Release 11 — 6 months, dose 1
Symptoms: Was pregnant and didn't know when I received my 2nd shot. Pregnancy ended in an early miscarriage.
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 | Abortion spontaneous | · | · | ✓ |
| SD | Injection site reaction | · | · | ✓ |
| SD | Menstrual disorder | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Rash papular | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release