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XMA-12294-53433

3 vaccinations 5 coded responses 37 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
31-35
ZIP prefix
068 / CT
Registered
2021-03-03
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
8VJ-25815-33266 Child or adolescent in my care · Male · 2022-06-28
BBP-56966-20576 Child or adolescent in my care · Female · 2022-06-28

Timeline

  1. 2021-03-02
    Dose 1 — Moderna
  2. 2021-03-03
    Registered in v-safe
  3. 2021-03-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  4. 2021-03-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  6. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-09
    Health check-in — day 7, dose 1
    Feeling: Good · Diarrhea, Abdominal pain
    Adult check-in
  10. 2021-03-16
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-23
    Survey response — day 21, dose 1
    MedDRA: Nephrolithiasis — Feeling: Good
    Free text: Kidney stone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-30
    Dose 2 — Moderna
  13. 2021-03-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  14. 2021-04-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  15. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  17. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-04-06
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  20. 2021-04-13
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-22
    Survey response — day 21, dose 2
    MedDRA: Headache, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Vomiting, headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-04-22
    Report sent to call center — day 21, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2021-04-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-11
    Survey response — day 42, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Got a cold (likely from toddler in daycare). Both my kids, me, and my husband have mild cold symptoms. Have not gotten tested for COVID.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-06-29
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-09-28
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-11-28
    Dose 3 — Moderna
  29. 2021-11-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  30. 2021-11-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  31. 2021-12-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  32. 2021-12-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  33. 2021-12-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  34. 2021-12-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-12-05
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-12-12
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-12-21
    Survey response — day 21, dose 3
    MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair
    Free text: Cold symptoms following kids' Covid exposure at school. Took a rapid test and it was negative
    MedDRA releases: 2024-11 · check-in free text available
  38. 2021-12-26
    Survey response — day 28, dose 3
    MedDRA: Cough, Fatigue, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor
    Free text: Sore throat, congestion, fatigue, light cough. Kids had a covid exposure and both tested negative for covid. Have had two negative rapid tests and planning to take another tomorrow.
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-01-02
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-01-09
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-02-27
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  42. 2022-04-02
  43. 2022-05-29
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-02Moderna
22021-03-30Moderna
32021-11-28Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-22 Unsuccessful

Free text

Release 6 — day 21, dose 1

2021-03-23

Symptoms: Kidney stone

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Vomiting, headache

Release 8 — day 42, dose 2

2021-05-11

Symptoms: Got a cold (likely from toddler in daycare). Both my kids, me, and my husband have mild cold symptoms. Have not gotten tested for COVID.

Release 10 — day 21, dose 3

2021-12-21

Symptoms: Cold symptoms following kids' Covid exposure at school. Took a rapid test and it was negative

Release 10 — day 28, dose 3

2021-12-26

Symptoms: Sore throat, congestion, fatigue, light cough. Kids had a covid exposure and both tested negative for covid. Have had two negative rapid tests and planning to take another tomorrow.

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

FieldPreferred term2021-092023-042024-11
SDCough · · ✓
SDFatigue · · ✓
SDHeadache ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDNephrolithiasis ✓ ✓ ✓
SDOropharyngeal pain · · ✓
SDRespiratory tract congestion · · ✓
SDSARS-CoV-2 test negative · · ✓
SDUnevaluable event ✓ ✓ ✓
SDVomiting ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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