42B-23605-78874
4 vaccinations
10 coded responses
33 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 088 / NJ
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
- 2021-02-04
-
2021-02-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Musculoskeletal stiffness — Feeling: Good · Headache, Joint painsFree text: Headache might be because I did a craft while watching TV looking down a lot? Same thing with my stuff fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Joint painsFree text: Left hipMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-02
Dose 2 — Moderna
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2021-03-02
Survey response — day 0, dose 2MedDRA: Injection site pain, Injection site swelling — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: So on the arm with the shot, I notice in the middle of the arm a small raised bump with a dot in the middle, maybe a little sensitive to the touch. Maybe unrelated to the vaccine but didn't notice it yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Diarrhoea, Skin warm — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Shot area warm to the touch. My temperature is usually 96.0. I believe I have had diarrhea for a month now so maybe from the first shot. Not sureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Hyperhidrosis, Injection site pain, Injection site warmth, Nausea, Pyrexia, Vomiting — Feeling: Fair · Site: Pain · Fever · Chills · Be unable to do your normal daily activitiesFree text: Yesterday at 6pm temperature was 101.8, nauseous, vomited. Broke out in sweat. Site of injection still hot. Injection site hurts a little.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Self-medication, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Diarrhea · Be unable to do your normal daily activitiesFree text: Took 2 Tylenols for headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
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2021-06-03
Survey response — 3 months, dose 2MedDRA: Headache, Hypertension, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: My blood pressure very high, my blood sugar high, left had tingling, urinary inconvenience a bit, headache. · Healthcare visit (other): My doctor's office yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-31
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2021-11-29
Dose 3 — Moderna
- 2022-01-20
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2022-01-25
Call successfulDoes not wish to fill out VAERS report
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2022-04-20
Dose 4 — Moderna
- 2022-04-29
- 2022-05-04
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2022-05-11
Survey response — day 21, dose 4MedDRA: Hypertension, Stress — Feeling: GoodFree text: Maybe this happened before the 2nd booster but my blood pressure is high but I am going thru stressful time so really don't knowMedDRA releases: 2024-11 · check-in free text available
- 2022-05-18
- 2022-05-25
- 2022-06-01
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2022-07-21
Survey response — 3 months, dose 4MedDRA: Liver disorder — Feeling: FairFree text: Problem with my liverMedDRA releases: 2024-11 · check-in free text available
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2022-10-21
Survey response — 6 months, dose 4MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cold since last week. Just about done. Lungs clearMedDRA releases: 2024-11 · check-in free text available
- 2023-04-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-11-29 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Headache might be because I did a craft while watching TV looking down a lot? Same thing with my stuff fingers
Systemic reaction (other): Left hip
Release 4 — day 0, dose 2
Systemic reaction (other): So on the arm with the shot, I notice in the middle of the arm a small raised bump with a dot in the middle, maybe a little sensitive to the touch. Maybe unrelated to the vaccine but didn't notice it yesterday.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Shot area warm to the touch. My temperature is usually 96.0. I believe I have had diarrhea for a month now so maybe from the first shot. Not sure
Systemic reaction (other): Yesterday at 6pm temperature was 101.8, nauseous, vomited. Broke out in sweat. Site of injection still hot. Injection site hurts a little.
Systemic reaction (other): Took 2 Tylenols for headache
Release 8 — 3 months, dose 2
Symptoms: My blood pressure very high, my blood sugar high, left had tingling, urinary inconvenience a bit, headache.
Healthcare visit (other): My doctor's office yesterday
Release 11 — day 21, dose 4
Symptoms: Maybe this happened before the 2nd booster but my blood pressure is high but I am going thru stressful time so really don't know
Release 12 — 3 months, dose 4
Symptoms: Problem with my liver
Release 12 — 6 months, dose 4
Symptoms: Cold since last week. Just about done. Lungs clear
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 | Headache | ✓ | ✓ | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SD | Liver disorder | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Stress | · | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Skin warm | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release