Y24-55554-39912
4 vaccinations
7 coded responses
49 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 436 / OH
- Registered
- 2020-12-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
W2A-12971-24901
Child or adolescent in my care · Female · 2022-06-24
6NW-10628-55200
Child or adolescent in my care · Male · 2022-06-24
Timeline
-
2020-12-23
Registered in v-safe
-
2020-12-23
Dose 1 — Moderna
- 2020-12-27
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2021-01-06
- 2021-01-13
-
2021-01-20
Dose 2 — Moderna
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
-
2021-01-25
Survey response — days 1–6 daily, dose 2MedDRA: Upper respiratory tract infection — Feeling: GoodFree text: Newly with URI, +sick contactsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Upper respiratory tract infection — Feeling: GoodFree text: URI -improvingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-04-21
- 2021-07-21
-
2021-10-25
Dose 3 — Moderna
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
-
2021-12-06
Survey response — day 42, dose 3MedDRA: Herpes zoster — Feeling: FairFree text: ShinglesMedDRA releases: 2024-11 · check-in free text available
-
2022-01-24
Survey response — 3 months, dose 3MedDRA: Malignant melanoma, Nasopharyngitis, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Melanoma; currently with a cold but household contact negative for COVID after exposureMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Survey response — 6 months, dose 3MedDRA: Headache, Malignant melanoma, Respiratory symptom — 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 consultation, Outpatient clinic or urgent care clinic visitFree text: Melanoma, severe headaches along with viral URI symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-26
-
2022-09-26
Dose 4 — ModernaCo-administered: Flu
- 2022-09-26
- 2022-09-27
-
2022-09-28
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-09-29
-
2022-09-30
Health check-in — days 1–6 daily, dose 4Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2022-10-01
- 2022-10-02
-
2022-10-03
Survey response — day 7, dose 4MedDRA: Abortion spontaneous — Feeling: Poor · Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: MiscarriageMedDRA releases: 2024-11 · check-in free text available
-
2022-10-03
Report sent to call center — day 7, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2022-10-04
- 2022-10-04
-
2022-10-10
Survey response — day 14, dose 4MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · HospitalizationFree text: Miscarriage at 20 weeks; fetal size 17 weeksMedDRA releases: 2024-11 · check-in free text available
-
2022-10-10
Report sent to call center — day 14, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-10-11
- 2022-10-11
- 2022-10-11
-
2022-10-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-17
- 2022-10-26
- 2022-10-31
- 2022-11-07
- 2022-12-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-20 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-09-26 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-25 | Successful 2022-10-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-03 | Successful 2022-10-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-10 | Successful 2022-10-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Newly with URI, +sick contacts
Systemic reaction (other): URI -improving
Release 10 — day 42, dose 3
Symptoms: Shingles
Release 11 — 3 months, dose 3
Symptoms: Melanoma; currently with a cold but household contact negative for COVID after exposure
Release 11 — 6 months, dose 3
Symptoms: Melanoma, severe headaches along with viral URI symptoms
Release 12 — day 7, dose 4
Systemic reaction (other): Miscarriage
Release 12 — day 14, dose 4
Symptoms: Miscarriage at 20 weeks; fetal size 17 weeks
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 | Abortion spontaneous | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Malignant melanoma | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Abortion spontaneous | · | · | ✓ |
| SRO | Upper respiratory tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release