3GW-81303-14008
2 vaccinations
7 coded responses
14 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 070 / NJ
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
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2020-12-31
Survey response — days 1–6 daily, dose 1MedDRA: Discomfort, Flatulence — Feeling: Good · Site: Pain, Swelling · Abdominal painFree text: More like discomfort than pain and some Gas. But not sure it was the shot. Really no real issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Not related to the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-01
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-02
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2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Think it's just my typical pain issues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-03
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease, Sensitivity to weather change — Feeling: Good · Site: Pain · Muscle or body achesFree text: Probably weather related old injuryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-06
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Don't think it is related to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-14
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2021-01-19
Survey response — day 21, dose 1MedDRA: Facial bones fracture, Fall, Lip injury, Suture insertion, Unevaluable event — Feeling: Poor · 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 visitFree text: Symptoms: I fell broke my nose and had over 30 stitches in my lip yesterday. · Healthcare visit (other): See aboveMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-19
Report sent to call center — day 21, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-26
Dose 2 — Moderna
- 2021-01-26
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2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I was in an accident so I have no symptoms related to the vaccine. I live with pain everyday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-02-17
- 2021-04-28
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2021-04-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-07-27
- 2022-01-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-26 | Moderna |
Call center
3 call center cases
1 successful · 2 priority 2/3 (triaged and no follow up)
1 wait over 3 months for a first call
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): More like discomfort than pain and some Gas. But not sure it was the shot. Really no real issues
Systemic reaction (other): Not related to the vaccine
Systemic reaction (other): Think it's just my typical pain issues.
Systemic reaction (other): Probably weather related old injury
Release 1 — day 7, dose 1
Systemic reaction (other): Don't think it is related to vaccine
Release 2 — day 21, dose 1
Symptoms: I fell broke my nose and had over 30 stitches in my lip yesterday.
Healthcare visit (other): See above
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): I was in an accident so I have no symptoms related to the vaccine. I live with pain everyday.
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Facial bones fracture | ✓ | ✓ | ✓ |
| SD | Fall | ✓ | ✓ | ✓ |
| SD | Lip injury | ✓ | ✓ | ✓ |
| SD | Suture insertion | ✓ | · | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release