WXN-21279-92329
1 vaccination
4 coded responses
6 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 928 / CA
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Dose 1 — Moderna
-
2021-02-02
Registered in v-safe
-
2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: Feeding disorder — Feeling: Poor · Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: I can't eatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-03
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Vertigo, Weight decreased — Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, 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: Severe weight loss, vertigo, dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-03
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Urinary retention — Feeling: Poor · Site: Pain · Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: I can't peeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-06-19
- 2021-06-23
-
2021-07-19
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2021-07-31
-
2022-01-30
Survey response — 12 months, dose 1MedDRA: Unevaluable event — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: See belowMedDRA releases: 2024-11 · check-in free text available
-
2022-01-30
Report sent to call center — 12 months, dose 1Be 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 · Emergency room or emergency department visit · 1 call case(s)
- 2022-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-03 | Successful 2021-07-19 |
Reported to VAERS voluntarily prior to GDIT contact |
| 2022-01-30 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I can't eat
Systemic reaction (other): Severe weight loss, vertigo, dizziness
Systemic reaction (other): I can't pee
Release 11 — 12 months, dose 1
Symptoms: See below
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 | Unevaluable event | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeding disorder | ✓ | ✓ | ✓ |
| SRO | Urinary retention | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
| SRO | Weight decreased | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release