VW5-11520-47917
4 vaccinations
3 coded responses
50 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 927 / CA
- Registered
- 2021-03-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Registered in v-safe
-
2021-03-25
Dose 1 — Moderna
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
-
2021-04-22
Dose 2 — Moderna
-
2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-25
- 2021-04-26
- 2021-04-27
-
2021-04-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-07-22
- 2021-10-21
-
2021-11-03
Dose 3 — Moderna
- 2021-11-03
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Muscle or body achesAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
-
2022-02-02
Survey response — 3 months, dose 3MedDRA: Anosmia, Cough, Fatigue, Oropharyngeal pain, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cough, fever, sore throat, fatigue, unable to smell.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-06
-
2022-10-13
Dose 4 — Moderna
- 2022-10-13
-
2022-10-14
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-15
- 2022-10-16
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-27
- 2022-11-03
-
2022-11-10
Survey response — day 28, dose 4MedDRA: Cough, Pain, Pyrexia, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend schoolFree text: Low fever of 100.7, coughing, congestion, body achesMedDRA releases: 2024-11 · check-in free text available
-
2022-11-17
Survey response — day 35, dose 4MedDRA: Ageusia, Anosmia, Cough, Ear infection, Pyrexia, Rash, Vomiting — 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 · Outpatient clinic or urgent care clinic visitFree text: Double ear infection, fever, loss of taste and smell, coughing to the point of vomiting, rash on palmsMedDRA releases: 2024-11 · check-in free text available
-
2022-11-17
Report sent to call center — day 35, 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)
- 2022-11-18
- 2022-11-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-10-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-17 | Unsuccessful |
Free text
Release 11 — 3 months, dose 3
Symptoms: Cough, fever, sore throat, fatigue, unable to smell.
Release 12 — day 28, dose 4
Symptoms: Low fever of 100.7, coughing, congestion, body aches
Release 12 — day 35, dose 4
Symptoms: Double ear infection, fever, loss of taste and smell, coughing to the point of vomiting, rash on palms
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 | Ear infection | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release