XR8-31405-11982
3 vaccinations
3 coded responses
23 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 933 / CA
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 1 — Moderna
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-12
Survey response — day 14, dose 1MedDRA: Fatigue, Headache, Pain — Feeling: FairFree text: Achy, headache, tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-21
-
2021-03-26
Dose 2 — Moderna
-
2021-03-26
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Abdominal painAdult check-in
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-25
- 2021-04-30
- 2021-05-07
- 2021-06-27
-
2021-09-24
Survey response — 6 months, dose 2MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Covid19MedDRA releases: 2024-11 · check-in free text available
-
2021-09-24
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-09-27
-
2021-09-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-01-10
Dose 3 — Moderna
-
2022-07-11
Survey response — 6 months, dose 3MedDRA: Bronchitis — Feeling: Good · Be unable to work or attend schoolFree text: BronchitisMedDRA releases: 2024-11 · check-in free text available
- 2023-01-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2022-01-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-24 | Successful 2021-09-27 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 5 — day 14, dose 1
Symptoms: Achy, headache, tired
Release 9 — 6 months, dose 2
Symptoms: Covid19
Release 12 — 6 months, dose 3
Symptoms: Bronchitis
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 | Bronchitis | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release