Z3C-17027-36686
2 vaccinations
3 coded responses
16 check-ins
3 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 551 / MN
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-16
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-18
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Back pain, Dysstasia, Pain — Feeling: Fair · Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: The right side of my lower back is completely out. I cannot bend forward, especially towards the right or stand without pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-15
Dose 2 — Moderna
- 2021-02-25
- 2021-03-03
- 2021-03-08
- 2021-03-15
-
2021-05-18
Survey response — 3 months, dose 2MedDRA: Chills, Diarrhoea, Tremor — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Diahrea. Shakes, chills. No fever.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-16
Survey response — 6 months, dose 2MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: PregnancyMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-16
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-16 | priority 2/3 | |
| 2021-01-17 | priority 2/3 | |
| 2021-01-18 | priority 2/3 | |
| 2021-08-16 | Successful 2021-08-19 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): The right side of my lower back is completely out. I cannot bend forward, especially towards the right or stand without pain.
Release 8 — 3 months, dose 2
Symptoms: Diahrea. Shakes, chills. No fever.
Release 9 — 6 months, dose 2
Symptoms: Pregnancy
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 | Chills | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Pregnancy | ✓ | · | ✓ |
| SD | Tremor | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dysstasia | ✓ | · | ✓ |
| SRO | Pain | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release