YXE-23437-89597
4 vaccinations
2 coded responses
37 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 917 / CA
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
CRU-97814-05763
Child or adolescent in my care · Female · 2022-06-22
Timeline
-
2021-03-18
Dose 1 — Moderna
-
2021-03-19
Registered in v-safe
- 2021-03-19
- 2021-03-20
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
-
2021-04-16
Dose 2 — Moderna
-
2021-04-16
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Skin sensitisation — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Skin sensitivityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-07-16
- 2021-10-15
-
2021-11-19
Dose 3 — Moderna
- 2022-04-16
-
2022-09-13
Dose 4 — Pfizer-BioNTech
- 2022-09-13
-
2022-09-14
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-22
- 2022-09-27
- 2022-10-06
- 2022-10-11
- 2022-10-18
- 2022-10-27
-
2022-12-13
Survey response — 3 months, dose 4MedDRA: Gallbladder disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Gallbladder diseaseMedDRA releases: 2024-11 · check-in free text available
-
2022-12-13
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-16 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-09-13 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-13 | Successful 2022-12-14 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Skin sensitivity
Release 12 — 3 months, dose 4
Symptoms: Gallbladder disease
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 | Gallbladder disorder | · | · | ✓ |
| SRO | Skin sensitisation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release