2ES-11688-82761
2 vaccinations
7 coded responses
14 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 956 / CA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Pfizer-BioNTech
-
2021-01-21
Registered in v-safe
- 2021-01-21
- 2021-01-23
- 2021-01-25
- 2021-01-26
- 2021-02-03
-
2021-02-09
Dose 2 — Moderna
-
2021-02-09
Survey response — day 0, dose 2MedDRA: Vaccination error — Feeling: Poor · Site: Pain · FeverFree text: I was given Mederna on my 2nd does by mistake when my 1st was PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: 2nd injection was Moderna in error of first short PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Interchange of vaccine products — Feeling: Good · Site: PainFree text: Moderna given for 2nd shot in error. 1st shot PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Wrong product administered — Feeling: Good · Site: PainFree text: 2nd injection Moderna was given in error of the 1st injection of PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: Given Moderna for 2nd shot, but 1st shot was PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Interchange of vaccine products, Wrong product administered — Feeling: Good · Site: PainFree text: Error in 2nd shot Moderna when 1st shot was PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Survey response — day 7, dose 2MedDRA: Interchange of vaccine products — Feeling: Good · Site: PainFree text: Error in dose: 2nd dose given Moderna. 1st dose PfizerMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-08-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Pfizer-BioNTech | |
| 2 | 2021-02-09 | Moderna |
Free text
Release 3 — day 0, dose 2
Systemic reaction (other): I was given Mederna on my 2nd does by mistake when my 1st was Pfizer
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): 2nd injection was Moderna in error of first short Pfizer
Systemic reaction (other): Moderna given for 2nd shot in error. 1st shot Pfizer
Systemic reaction (other): 2nd injection Moderna was given in error of the 1st injection of Pfizer
Systemic reaction (other): Given Moderna for 2nd shot, but 1st shot was Pfizer
Systemic reaction (other): Error in 2nd shot Moderna when 1st shot was Pfizer
Release 4 — day 7, dose 2
Systemic reaction (other): Error in dose: 2nd dose given Moderna. 1st dose Pfizer
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 |
|---|---|---|---|---|
| SRO | Interchange of vaccine products | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vaccination error | ✓ | ✓ | ✓ |
| SRO | Wrong product administered | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release