XAZ-23775-36251
3 vaccinations
2 coded responses
20 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 113 / NY
- Registered
- 2021-02-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Dose 1 — Moderna
-
2021-02-08
Dose 2 — Moderna
-
2021-02-20
Registered in v-safe
- 2021-02-20
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-24
- 2021-05-12
- 2021-08-09
-
2021-10-23
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
-
2021-11-27
Survey response — day 35, dose 3MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend schoolFree text: A bad coldMedDRA releases: 2024-11 · check-in free text available
- 2021-12-04
- 2022-01-22
- 2022-04-23
-
2022-10-23
Survey response — 12 months, dose 3MedDRA: COVID-19 — 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 consultationFree text: CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-10-23
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 · 1 call case(s)
-
2022-10-25
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-23 | Successful 2022-10-25 |
Not applicable - Accidental Reporting |
Free text
Release 10 — day 35, dose 3
Symptoms: A bad cold
Release 12 — 12 months, dose 3
Symptoms: Covid
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 | COVID-19 | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release