YHM-13685-81753
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 128 / NY
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-11
- 2021-01-12
- 2021-01-19
- 2021-01-26
-
2021-02-02
Survey response — 28 day, dose 1MedDRA: Abdominal pain, Back pain, Hospitalisation, Thrombosis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-02
Report sent to call center — 28 day, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-09
Dose 2 — Moderna
- 2021-02-25
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
-
2021-05-11
Survey response — 3 month, dose 2MedDRA: Office visit, Thrombosis, Uterine polyp — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-11
Report sent to call center — 3 month, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
- 2021-08-10
- 2022-02-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-02 | Unsuccessful | |
| 2021-05-11 | Unsuccessful |
Free text
Release 3
Symptoms: I am currently in hospital. Have a blood clot in vein that supplies blood to stomach. Severe abdominal pain radiating to back.
Release 8
Symptoms: When I was in the hospital in Feb for a blood clot they also found a polyp in my uterus. Had to have d&c and polyp removal in April. Tomorrow I am having a hysterectomy.
Healthcare visit (other): In person doctors visit.
Free-text releases are not linked to a specific 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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Thrombosis | ✓ | ✓ | ✓ |
| SD | Uterine polyp | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release