X37-93097-19347
4 vaccinations
1 coded response
45 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 201 / VA
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
X9F-30795-35822
Child or adolescent in my care · Male · 2022-07-09
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
- 2020-12-31
-
2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-01-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-13
- 2021-01-22
-
2021-01-27
Dose 2 — Moderna
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
-
2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-02-03
- 2021-02-11
- 2021-02-20
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-04-28
- 2021-07-28
-
2021-11-01
Dose 3 — Moderna
-
2021-11-01
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
-
2022-01-31
Survey response — 3 months, dose 3MedDRA: Abdominal pain lower, Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Respiratory tract congestion, Sneezing — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Lower abdominal pain persisting for several weeks (onset December 2021). COVID-19 diagnosis after onset of coughing, congestion, loss of taste and smell, headache, fatigue, sneezing on 1/8/22.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-31
Report sent to call center — 3 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 prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-02-01
-
2022-02-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-02
-
2022-10-08
Dose 4 — Moderna
- 2022-10-24
- 2022-10-29
- 2022-11-05
- 2022-11-12
- 2022-11-19
- 2023-01-07
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-10-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-31 | Successful 2022-02-04 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 11 — 3 months, dose 3
Symptoms: Lower abdominal pain persisting for several weeks (onset December 2021). COVID-19 diagnosis after onset of coughing, congestion, loss of taste and smell, headache, fatigue, sneezing on 1/8/22.
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 | Abdominal pain lower | · | · | ✓ |
| SD | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release