VSS-15584-69713
5 vaccinations
1 coded response
33 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 720 / AR
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-14
- 2021-01-19
- 2021-01-26
-
2021-02-02
Dose 2 — Moderna
-
2021-02-09
Health check-in — day 7, dose 2Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2021-11-04
Dose 3 — Moderna
- 2022-02-02
- 2022-02-03
-
2022-04-20
Dose 4 — Moderna
- 2022-04-21
-
2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-07-20
-
2022-10-19
Survey response — 6 months, dose 4MedDRA: COVID-19, Influenza like illness — Feeling: Fair · Be unable to work or attend school, 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: COVID 09.09.22 Flu like virus 10.08.22MedDRA releases: 2024-11 · check-in free text available
-
2022-10-19
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-11-01
Dose 5 — Moderna
- 2023-05-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
| 5 | 2022-11-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-19 | Successful 2022-10-20 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 6 months, dose 4
Symptoms: COVID 09.09.22 Flu like virus 10.08.22
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 | COVID-19 | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release