4BP-11712-90602
2 vaccinations
4 coded responses
12 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 010 / MA
- Registered
- 2021-03-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-13
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-14
Registered in v-safe
-
2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tirednessFree text: When I bend over, my head aches a little, but when I straighten up, the pain goes away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia, Pain in extremity — Feeling: Good · Site: PainFree text: Pain in the arm I got the shot in woke me during the night. It bothered me while I was driving today, but other than that, it wasnt too bad. It hurts mostly in the bicep area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: Arm that I got the shot in is still a little sore today. Not at the site, mostly the bicep. It isnt nearly as bothersome as yesterday, though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-18
- 2021-06-14
- 2021-09-11
-
2021-11-07
Dose 2 — Moderna
- 2021-11-07
-
2021-11-08
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: GoodFree text: Can feel it only if I touch my arm or lift it over my head, but it doesn't hurt.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-10
- 2021-11-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-07 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): When I bend over, my head aches a little, but when I straighten up, the pain goes away.
Systemic reaction (other): Pain in the arm I got the shot in woke me during the night. It bothered me while I was driving today, but other than that, it wasnt too bad. It hurts mostly in the bicep area.
Systemic reaction (other): Arm that I got the shot in is still a little sore today. Not at the site, mostly the bicep. It isnt nearly as bothersome as yesterday, though.
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Can feel it only if I touch my arm or lift it over my head, but it doesn't hurt.
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 |
|---|---|---|---|---|
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release