3JZ-30709-56159
4 vaccinations
6 coded responses
36 check-ins
5 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 117 / NY
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
- 2020-12-31
-
2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-08
- 2021-01-13
- 2021-01-22
- 2021-01-27
-
2021-01-28
Dose 2 — Moderna
- 2021-02-01
-
2021-02-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-04
- 2021-02-11
- 2021-02-25
- 2021-03-04
-
2021-03-11
Survey response — day 42, dose 2MedDRA: Pre-existing disease, Psoriatic arthropathy — Feeling: GoodFree text: My psoriatic arthritis is having a flare-up.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Survey response — 3 months, dose 2MedDRA: Pre-existing disease, Psoriatic arthropathy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: My psoriatic arthritis has been exacerbated.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-29
-
2021-08-19
Dose 3 — Moderna
- 2021-11-18
-
2022-02-19
Survey response — 6 months, dose 3MedDRA: Office visit, Pre-existing disease, Psoriatic arthropathy — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Psoriatic arthritis has been exacerbated since receiving the Moderns booster. · Healthcare visit (other): OfficeMedDRA releases: 2024-11 · check-in free text available
-
2022-02-19
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-03
Call successfulParticipant prefers to complete VAERS report online
-
2022-05-14
Dose 4 — Moderna
-
2022-05-14
Health check-in — day 0, dose 4Feeling: Good · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-05-16
- 2022-05-17
- 2022-05-18
- 2022-05-19
- 2022-05-20
- 2022-05-23
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-06-18
-
2022-06-26
Survey response — day 42, dose 4MedDRA: Medical counselling, Pre-existing disease, Psoriatic arthropathy, Vaccine positive rechallenge — Feeling: FairFree text: Psoriatic Arthritis has been flaring more and more severe. This occurred after rach vaccine dose. My rheumatologist said she has had many similar complaints.MedDRA releases: 2024-11 · check-in free text available
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2022-08-15
Survey response — 3 months, dose 4MedDRA: Office visit, Pre-existing disease, Psoriatic arthropathy — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Psoriatic arthritis has been aggravated since getting initial vax and subsequent booster. · Healthcare visit (other): Office visitsMedDRA releases: 2024-11 · check-in free text available
-
2022-08-15
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-08-16
Call successfulParticipant prefers to complete VAERS report online
- 2022-11-12
-
2023-05-14
Survey response — 12 months, dose 4MedDRA: Pneumonia, Psoriatic arthropathy — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationMedDRA releases: 2024-11
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2023-05-14
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2023-05-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-08-19 | Moderna | No |
| 4 | 2022-05-14 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 5 — day 42, dose 2
Symptoms: My psoriatic arthritis is having a flare-up.
Release 8 — 3 months, dose 2
Symptoms: My psoriatic arthritis has been exacerbated.
Release 11 — 6 months, dose 3
Symptoms: Psoriatic arthritis has been exacerbated since receiving the Moderns booster.
Healthcare visit (other): Office
Release 12 — day 42, dose 4
Symptoms: Psoriatic Arthritis has been flaring more and more severe. This occurred after rach vaccine dose. My rheumatologist said she has had many similar complaints.
Release 12 — 3 months, dose 4
Symptoms: Psoriatic arthritis has been aggravated since getting initial vax and subsequent booster.
Healthcare visit (other): Office visits
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 | Office visit | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Psoriatic arthropathy | ✓ | ✓ | ✓ |
| SD | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release