3LK-32021-33773
2 vaccinations
5 coded responses
18 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 088 / NJ
- Registered
- 2020-12-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-23
Dose 1 — Moderna
-
2020-12-24
Registered in v-safe
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2020-12-25
Survey response — days 1–6 daily, dose 1MedDRA: Nasal congestion, Sneezing — Feeling: Good · Site: Pain · HeadacheFree text: Sneezing and mild nasal congestion (not sure if related to vaccine)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-27
- 2020-12-28
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2020-12-29
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, NauseaAdult check-in
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2020-12-30
Health check-in — day 7, dose 1Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-01-06
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2021-01-13
Survey response — day 21, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Injection site previously had no pain after a couple of day. Late last week had new sore was at the Injection site. Self limiting and wasn't intolerableMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-20
Dose 2 — Moderna
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2021-01-21
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia, Back pain, Dizziness, Ear pain, Eye pain, Hypotension, Malaise, Vertigo — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Dizziness/vertigo. Low blood pressure ear pain eyes pain back pain general malaise and weaknessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-22
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Headache, Lymphadenopathy, Pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Had T max 100.8 during night than woke up with T- 96. Swollen lymph nodes. Stabbing Pain in the opposite arm of the injection site Was sitting in bed last night and had different sharp stabbing pains in a different area of head (not same as previous headache ) and shooting pain in opposite armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-29
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2021-02-03
Survey response — day 14, dose 2MedDRA: Condition aggravated, Fatigue, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fatigue and exacerbation of auto immune disease (ulcerative colitis )MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-18
- 2021-03-03
- 2021-07-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-20 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Sneezing and mild nasal congestion (not sure if related to vaccine)
Release 1 — day 21, dose 1
Symptoms: Injection site previously had no pain after a couple of day. Late last week had new sore was at the Injection site. Self limiting and wasn't intolerable
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Dizziness/vertigo. Low blood pressure ear pain eyes pain back pain general malaise and weakness
Systemic reaction (other): Had T max 100.8 during night than woke up with T- 96. Swollen lymph nodes. Stabbing Pain in the opposite arm of the injection site Was sitting in bed last night and had different sharp stabbing pains in a different area of head (not same as previous headache ) and shooting pain in opposite arm
Release 3 — day 14, dose 2
Symptoms: Fatigue and exacerbation of auto immune disease (ulcerative colitis )
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 |
|---|---|---|---|---|
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hypotension | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release