XB8-21794-96713
2 vaccinations
3 coded responses
13 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 449 / OH
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-01-06
Dose 1 — Moderna
-
2021-01-19
Registered in v-safe
- 2021-01-19
-
2021-02-03
Dose 2 — Moderna
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Nausea, Abdominal painAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-09
- 2021-02-10
- 2021-02-17
-
2021-02-24
Survey response — day 21, dose 2MedDRA: Abortion spontaneous — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Loss of pregnancyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-24
Report sent to call center — day 21, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-10
Survey response — day 35, dose 2MedDRA: Pain, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Vomiting, body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
-
2021-05-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-05-07
-
2021-08-04
Survey response — 6 months, dose 2MedDRA: Cough, Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Congestion, cough,sore throatMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2022-02-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-24 | Successful 2021-05-04 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4 — day 21, dose 2
Symptoms: Loss of pregnancy
Release 5 — day 35, dose 2
Symptoms: Vomiting, body aches
Release 9 — 6 months, dose 2
Symptoms: Congestion, cough,sore throat
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release