X7N-25661-00429
4 vaccinations
3 coded responses
45 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 450 / OH
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
GKT-31966-42434
Child or adolescent in my care · Female · 2021-11-05
2Q9-82655-16212
Child or adolescent in my care · Female · 2021-11-26
Timeline
-
2021-03-15
Registered in v-safe
-
2021-03-15
Dose 1 — Moderna
- 2021-03-15
-
2021-03-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-03-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
-
2021-04-12
Dose 2 — Moderna
-
2021-04-12
Health check-in — day 0, dose 2Feeling: Fair · Site: Swelling · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-07-12
- 2021-10-11
-
2021-10-29
Dose 3 — Moderna
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-31
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: FairFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-14
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
-
2022-01-28
Survey response — 3 months, dose 3MedDRA: Office visit, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Runny nose · Healthcare visit (other): Allergy doctorMedDRA releases: 2024-11 · check-in free text available
-
2022-01-28
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-03
- 2022-04-29
-
2022-05-21
Dose 4 — Moderna
- 2022-06-20
- 2022-07-02
- 2022-08-22
- 2022-11-21
- 2023-05-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Moderna | |
| 2 | 2021-04-12 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-28 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Stuffy nose
Systemic reaction (other): Runny nose
Release 11 — 3 months, dose 3
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release