36A-32600-55196
2 vaccinations
5 coded responses
26 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 088 / NJ
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 1 — Moderna
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-05-06
Dose 2 — Moderna
-
2021-05-06
Survey response — day 0, dose 2MedDRA: Nausea — Feeling: Good · Site: PainFree text: Queasy stomach but its mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: The chills were severe with my body shaking for 3 plus hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-08
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia, Neuropathy peripheral — Feeling: Fair · Site: Pain · Headache, Muscle or body achesFree text: Since 2nd shot symptoms of numbness due to my peripheral neuropathy are more evident. Maybe coincidence to timing of shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-09
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia, Neuropathy peripheral, Pre-existing disease — Feeling: GoodFree text: Still have numbness from PN flare since shot- again it could be a coincidence and not related to the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-10
-
2021-05-11
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Condition aggravated, Hypoaesthesia, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: Still have numbness from PN flare may not be related though it started after severe chillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-06-17
- 2021-08-05
- 2021-11-04
- 2022-05-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna | |
| 2 | 2021-05-06 | Moderna |
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): Queasy stomach but its mild.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): The chills were severe with my body shaking for 3 plus hours
Systemic reaction (other): Since 2nd shot symptoms of numbness due to my peripheral neuropathy are more evident. Maybe coincidence to timing of shot
Systemic reaction (other): Still have numbness from PN flare since shot- again it could be a coincidence and not related to the shot
Systemic reaction (other): Still have numbness from PN flare may not be related though it started after severe chills
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 | Chills | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Neuropathy peripheral | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release