WQW-19531-00921
3 vaccinations
4 coded responses
28 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 074 / NJ
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
YS6-14015-22423
Child or adolescent in my care · Female · 2021-08-30
6MU-30937-08675
Child or adolescent in my care · Male · 2021-12-08
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-02-05
Registered in v-safe
- 2021-02-05
-
2021-02-10
Dose 2 — Moderna
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Neuralgia — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Severe neck painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-12-06
Dose 3 — Moderna
-
2021-12-08
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-12-10
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Underarm painMedDRA releases: 2024-11 · check-in free text available
-
2021-12-11
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain — Feeling: Good · Site: PainFree text: Underarm painMedDRA releases: 2024-11 · check-in free text available
- 2021-12-12
- 2021-12-13
- 2021-12-20
- 2021-12-28
- 2022-01-04
- 2022-01-12
- 2022-01-19
- 2022-03-07
- 2022-06-08
-
2022-12-06
Survey response — 12 months, dose 3MedDRA: Bronchitis, Dyspnoea, Pyrexia, Sinus headache — Feeling: Good · Be unable to work or attend school, 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: Bronchitis, Shortness of breath, fever, sinus headachesMedDRA releases: 2024-11 · check-in free text available
-
2022-12-06
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-07
-
2022-12-07
Callback requested for10:00AM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-12-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-06 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Severe neck pain
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Underarm pain
Systemic reaction (other): Underarm pain
Release 12 — 12 months, dose 3
Symptoms: Bronchitis, Shortness of breath, fever, sinus headaches
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 | Bronchitis | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Neuralgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release