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2JX-26096-85087

3 vaccinations 4 coded responses 27 check-ins 4 free-text entries 4 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
900 / CA
Registered
2021-01-15
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-15
    Registered in v-safe
  2. 2021-01-15
    Dose 1 — Moderna
  3. 2021-01-15
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · None
    Adult check-in
  5. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-01-18
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  7. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  9. 2021-01-22
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  10. 2021-01-29
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-07
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-14
    Survey response — day 28, dose 1
    MedDRA: Atrioventricular block complete, Atrioventricular block first degree, Cardiac pacemaker insertion, Hospitalisation, Surgery — Feeling: Fair · 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, Hospitalization
    Free text: I was diagnosed with third degree heart blockage and was hospitalized for pacemaker surgery.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-14
    Report sent to call center — day 28, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-02-19
    Survey response — day 35, dose 1
    MedDRA: Cardiac pacemaker adjustment, Complication associated with device, Emergency care, Hospitalisation, Medical counselling — Feeling: Fair · 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, Hospitalization
    Free text: My pacemaker was causing me to feel pulsating on my left side. My doctor told me to go to the ER so I went, and I was admitted to the hospital. The pacemaker was adjusted and I was released after an overnight stay.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-19
    Report sent to call center — day 35, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-02-26
    Dose 2 — Moderna
  17. 2021-02-26
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  19. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches, Abdominal pain · Be unable to work
    Adult check-in
  20. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Chills, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  21. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  22. 2021-03-05
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  23. 2021-03-12
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-19
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-26
    Survey response — day 28, dose 2
    MedDRA: Pain — Feeling: Fair
    Free text: Pain in my left side.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-04-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-04-09
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  28. 2021-05-28
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-08-02
  30. 2021-08-05
  31. 2021-08-27
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  32. 2021-12-20
    Dose 3 — Pfizer-BioNTech
  33. 2022-02-26
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  34. 2022-03-21
    Survey response — 3 months, dose 3
    MedDRA: Arthroscopy, Physiotherapy — 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 consultation
    Free text: I had arthroscopic knee surgery on my right knee on March 4, 2022. I'm now in physical therapy.
    MedDRA releases: 2024-11 · check-in free text available
  35. 2022-03-21
    Report sent to call center — 3 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  36. 2022-03-28
  37. 2022-04-05
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  38. 2022-06-20
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-12-20
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-15Moderna
22021-02-26Moderna
32021-12-20Pfizer-BioNTech No

Call center

4 call center cases

3 successful · 1 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 28, dose 1

2021-02-14

Symptoms: I was diagnosed with third degree heart blockage and was hospitalized for pacemaker surgery.

Release 4 — day 35, dose 1

2021-02-19

Symptoms: My pacemaker was causing me to feel pulsating on my left side. My doctor told me to go to the ER so I went, and I was admitted to the hospital. The pacemaker was adjusted and I was released after an overnight stay.

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Pain in my left side.

Release 11 — 3 months, dose 3

2022-03-21

Symptoms: I had arthroscopic knee surgery on my right knee on March 4, 2022. I'm now in physical therapy.

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

FieldPreferred term2021-092023-042024-11
SDArthroscopy · · ✓
SDAtrioventricular block complete ✓ · ✓
SDAtrioventricular block first degree ○ ✓ ○
SDCardiac pacemaker adjustment ✓ · ✓
SDCardiac pacemaker insertion ✓ · ✓
SDComplication associated with device ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDHospitalisation ✓ ✓ ✓
SDMedical counselling ✓ · ✓
SDPain ✓ ✓ ✓
SDPhysiotherapy · · ✓
SDSurgery ○ ✓ ○

✓ active code · ○ coded but marked inactive · blank = not in that release

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