WYA-99067-12289
1 vaccination
1 coded response
1 check-in
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 846 / UT
- Registered
- 2021-11-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-10-28
Dose 1 — Moderna
-
2021-11-18
Registered in v-safe
-
2021-11-18
Survey response — day 21, dose 1MedDRA: Bronchitis — 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 consultationFree text: BronchitisMedDRA releases: 2024-11 · check-in free text available
-
2021-11-18
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-11-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-10-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-18 | Unsuccessful |
Free text
Release 10 — day 21, dose 1
Symptoms: Bronchitis
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 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release