W4V-15716-36107
3 vaccinations
5 coded responses
39 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 070 / NJ
- Registered
- 2021-02-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Registered in v-safe
-
2021-02-25
Dose 1 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Site: PainFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
-
2021-03-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-11
-
2021-03-18
Survey response — day 21, dose 1MedDRA: Back pain, Depressed mood — Feeling: FairFree text: Lower back pain and lowered mood.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-25
Dose 2 — Moderna
- 2021-03-25
-
2021-03-26
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain upper, Hot flush — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Stomach ache, hot flashesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-06-24
- 2021-09-23
-
2021-12-30
Dose 3 — Moderna
-
2021-12-31
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2022-01-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2022-01-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-01-03
- 2022-01-04
- 2022-01-06
- 2022-01-13
- 2022-01-20
- 2022-01-27
- 2022-02-03
- 2022-02-10
- 2022-03-31
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2022-06-30
Survey response — 6 months, dose 3MedDRA: Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: PPDMedDRA releases: 2024-11 · check-in free text available
-
2022-06-30
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-01
- 2022-12-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2021-12-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-30 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness
Release 5 — day 21, dose 1
Symptoms: Lower back pain and lowered mood.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Stomach ache, hot flashes
Systemic reaction (other): Dizziness
Release 12 — 6 months, dose 3
Symptoms: PPD
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Depressed mood | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release