XX7-11341-34571
3 vaccinations
3 coded responses
27 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 300 / GA
- Registered
- 2021-03-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
BSH-15266-16463
Child or adolescent in my care · Male · 2021-12-02
XZC-21191-97700
Child or adolescent in my care · Male · 2021-12-02
NBQ-15403-04194
Child or adolescent in my care · Female · 2021-12-02
Timeline
-
2021-03-20
Registered in v-safe
-
2021-03-20
Dose 1 — Moderna
-
2021-03-20
Survey response — day 0, dose 1MedDRA: Myalgia — Feeling: Good · Muscle or body achesFree text: Left muscle pains up the left side of my neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Moderna
- 2021-04-17
-
2021-04-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-04-19
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-26
- 2021-05-01
- 2021-05-08
- 2021-05-15
-
2021-05-25
Survey response — day 35, dose 2MedDRA: Cough, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cough, sore throat, congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-29
- 2021-07-17
-
2021-09-02
Dose 3 — ModernaCo-administered: Flu
- 2021-10-16
- 2021-12-02
- 2022-03-03
-
2022-09-02
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: Had COVID 2 weeks agoMedDRA releases: 2024-11 · check-in free text available
-
2022-09-02
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)
- 2022-09-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-09-02 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-09-02 | Unsuccessful |
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Left muscle pains up the left side of my neck
Release 8 — day 35, dose 2
Symptoms: Cough, sore throat, congestion
Release 12 — 12 months, dose 3
Symptoms: Had COVID 2 weeks ago
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 | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release