XYH-24088-44650
3 vaccinations
3 coded responses
30 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 140 / NY
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JJM-28709-47392
Child or adolescent in my care · Male · 2021-12-07
Y9K-71155-59654
Child or adolescent in my care · Male · 2021-12-07
KUL-10334-88552
Child or adolescent in my care · Male · 2021-12-07
L8H-16139-44753
Adult relative or friend · Male · 2021-12-13
Timeline
-
2021-04-05
Dose 1 — Moderna
-
2021-04-08
Registered in v-safe
-
2021-04-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-19
-
2021-05-03
Dose 2 — Moderna
- 2021-05-03
-
2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-06-11
- 2021-06-14
- 2021-08-02
-
2021-12-07
Dose 3 — Moderna
-
2021-12-08
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-09
-
2021-12-11
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia — Feeling: Good · HeadacheFree text: Insomnia ~3 nightsMedDRA releases: 2024-11 · check-in free text available
- 2021-12-12
- 2021-12-16
- 2021-12-21
- 2022-01-06
-
2022-01-12
Survey response — day 35, dose 3MedDRA: Cough — Feeling: GoodFree text: Mild dry coughMedDRA releases: 2024-11 · check-in free text available
- 2022-01-18
- 2022-03-08
-
2022-12-07
Survey response — 12 months, dose 3MedDRA: Sinusitis — 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 · Outpatient clinic or urgent care clinic visitFree text: SinusitisMedDRA releases: 2024-11 · check-in free text available
-
2022-12-07
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-05 | Moderna | |
| 2 | 2021-05-03 | Moderna | |
| 3 | 2021-12-07 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-07 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Insomnia ~3 nights
Release 10 — day 35, dose 3
Symptoms: Mild dry cough
Release 12 — 12 months, dose 3
Symptoms: Sinusitis
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 | Sinusitis | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release