XGY-13209-28116
4 vaccinations
7 coded responses
23 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 029 / RI
- Registered
- 2021-05-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
339-82465-77482
Child or adolescent in my care · Male · 2022-07-08
LAS-23422-73721
Child or adolescent in my care · Male · 2022-09-11
Timeline
-
2021-04-15
Dose 1 — Moderna
-
2021-05-13
Dose 2 — Moderna
-
2021-05-17
Registered in v-safe
-
2021-05-17
Survey response — days 1–6 daily, dose 2MedDRA: Throat irritation — Feeling: Good · Site: Redness, ItchingFree text: Very slight irritation L side of throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-18
- 2021-05-20
- 2021-05-27
- 2021-06-03
-
2021-06-10
Survey response — day 28, dose 2MedDRA: Body temperature increased — Feeling: GoodFree text: Slightly elevated T. bili on routine lab work. Previously has always been within normal limits. No symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-17
- 2021-06-24
- 2021-08-12
- 2021-11-11
-
2021-11-16
Dose 3 — Moderna
-
2022-05-13
Survey response — 12 months, dose 2MedDRA: Pregnancy — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: PregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-05-13
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2022-05-16
-
2022-09-12
Dose 4 — Moderna
- 2022-09-12
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
-
2022-09-26
Survey response — day 14, dose 4MedDRA: Dysphonia, Oropharyngeal pain — Feeling: GoodFree text: Sore throat, hoarse voiceMedDRA releases: 2024-11 · check-in free text available
-
2022-10-03
Survey response — day 21, dose 4MedDRA: Respiratory tract congestion — Feeling: GoodFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
- 2022-10-10
- 2022-10-17
-
2022-10-24
Survey response — day 42, dose 4MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-12-12
Survey response — 3 months, dose 4MedDRA: Dysphonia, Lymphadenopathy, Pain, Respiratory tract congestion — Feeling: GoodFree text: Body aches, swollen lymph nodes, hoarseness, congestionMedDRA releases: 2024-11 · check-in free text available
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna | |
| 3 | 2021-11-16 | Moderna | No |
| 4 | 2022-09-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-13 | Unsuccessful |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Very slight irritation L side of throat
Release 9 — day 28, dose 2
Symptoms: Slightly elevated T. bili on routine lab work. Previously has always been within normal limits. No symptoms.
Release 11 — 12 months, dose 2
Symptoms: Pregnancy
Release 12 — day 14, dose 4
Symptoms: Sore throat, hoarse voice
Release 12 — day 21, dose 4
Symptoms: Congestion
Release 12 — day 42, dose 4
Symptoms: Sore throat
Release 12 — 3 months, dose 4
Symptoms: Body aches, swollen lymph nodes, hoarseness, congestion
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 | Body temperature increased | ✓ | ✓ | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release