Y8W-33652-50737
3 vaccinations
1 coded response
20 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 194 / PA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
3K4-28996-13225
Child or adolescent in my care · Female · 2022-06-28
PCX-59092-60817
Child or adolescent in my care · Male · 2022-06-28
Timeline
-
2021-03-21
Dose 1 — Moderna
-
2021-04-01
Registered in v-safe
- 2021-04-01
- 2021-04-04
- 2021-04-11
-
2021-04-18
Dose 2 — Moderna
-
2021-04-18
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-05-02
- 2021-05-09
- 2021-05-16
- 2021-05-23
- 2021-05-30
- 2021-07-18
- 2021-10-19
-
2021-11-04
Dose 3 — Moderna
-
2022-02-03
Survey response — 3 months, dose 3MedDRA: Dizziness, Dyspnoea, Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive — 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: I can't remember when I last checked in, but I tested positive for covid 1/9/22. I experienced fatigue, shortness of breath, headaches, congestion, a sore throat and lightheadedness.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-03
Report sent to call center — 3 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)
-
2022-02-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-21 | Moderna | |
| 2 | 2021-04-18 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-03 | Successful 2022-02-07 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 11 — 3 months, dose 3
Symptoms: I can't remember when I last checked in, but I tested positive for covid 1/9/22. I experienced fatigue, shortness of breath, headaches, congestion, a sore throat and lightheadedness.
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 | Dizziness | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release