3ZD-11955-09851
6 vaccinations
10 coded responses
81 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 087 / NJ
- Registered
- 2021-03-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-20
Registered in v-safe
-
2021-03-20
Dose 1 — Moderna
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Pain in extremity — Feeling: Good · Site: PainFree text: Slight headache yesterday when I got my injection and a little arm pain but that is gone todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Moderna
- 2021-04-17
-
2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Back pain, Middle insomnia — Feeling: Good · Joint pains, Muscle or body achesFree text: I had the joint pain last time but I thought it was because I was painting. My lower back both knees and shoulders ache and woke me up at 2 AM and I couldnt go back to sleep till 5 AM. But in the morning the joint pain was gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
-
2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Still feeling some joint pain in my knees and lower backMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Joint pain very mild todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
-
2021-04-24
Survey response — day 7, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Mild joint pain again today in my kneesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-07-17
- 2021-10-16
-
2021-10-22
Dose 3 — Moderna
-
2021-10-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-24
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Fair · Headache, Rash, not including the immediate area around the injection siteFree text: Rash on my abdomenMedDRA releases: 2024-11 · check-in free text available
- 2021-10-25
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Fatigue or tirednessAdult check-in
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: GoodFree text: Because I had the abdominal rash will be going to get tested to see if I am allergic to PEG or polysorbate 80MedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
-
2021-10-29
Survey response — day 7, dose 3MedDRA: Rash, Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: I may be allergic to PEG or polysorbate 80 and I have to check with an allergist because I got a rash from the booster shot only lasted 24 hours. And on my abdomenMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
-
2022-01-21
Survey response — 3 months, dose 3MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Went through allergy testing for PEG because I did get a mild rash with the booster. The Moderna component testing was inconclusive. The allergist would prefer if I need another vaccine that I get it there with an antihistamine as a precaution. · Healthcare visit (other): Allergist officeMedDRA releases: 2024-11 · check-in free text available
-
2022-01-21
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-01-25
-
2022-01-25
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-22
-
2022-05-18
Dose 4 — Pfizer-BioNTech
- 2022-05-18
- 2022-05-19
- 2022-05-20
- 2022-05-21
-
2022-05-22
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia, Rash, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: I feel so much better on the Pfizer vaccine. I had joint pain and a rash with Moderna inMedDRA releases: 2024-11 · check-in free text available
- 2022-05-23
- 2022-05-24
- 2022-05-25
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-08-17
-
2022-09-22
Dose 5 — Pfizer-BioNTech
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-12-22
- 2023-03-23
-
2023-04-26
Dose 6 — Pfizer-BioNTech
- 2023-04-26
- 2023-04-27
- 2023-04-28
- 2023-04-29
- 2023-04-30
- 2023-05-01
- 2023-05-02
- 2023-05-03
- 2023-05-10
- 2023-05-17
- 2023-05-24
- 2023-05-31
- 2023-06-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-05-18 | Pfizer-BioNTech | No |
| 5 | 2022-09-22 | Pfizer-BioNTech | No |
| 6 | 2023-04-26 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Slight headache yesterday when I got my injection and a little arm pain but that is gone today
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I had the joint pain last time but I thought it was because I was painting. My lower back both knees and shoulders ache and woke me up at 2 AM and I couldnt go back to sleep till 5 AM. But in the morning the joint pain was gone.
Systemic reaction (other): Still feeling some joint pain in my knees and lower back
Systemic reaction (other): Joint pain very mild today
Release 7 — day 7, dose 2
Systemic reaction (other): Mild joint pain again today in my knees
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Rash on my abdomen
Systemic reaction (other): Because I had the abdominal rash will be going to get tested to see if I am allergic to PEG or polysorbate 80
Release 10 — day 7, dose 3
Systemic reaction (other): I may be allergic to PEG or polysorbate 80 and I have to check with an allergist because I got a rash from the booster shot only lasted 24 hours. And on my abdomen
Release 11 — 3 months, dose 3
Symptoms: Went through allergy testing for PEG because I did get a mild rash with the booster. The Moderna component testing was inconclusive. The allergist would prefer if I need another vaccine that I get it there with an antihistamine as a precaution.
Healthcare visit (other): Allergist office
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): I feel so much better on the Pfizer vaccine. I had joint pain and a rash with Moderna in
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 | Rash | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release