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4DB-11636-32273

2 vaccinations 1 coded response 11 check-ins 1 free-text entry 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
070 / NJ
Registered
2021-01-08
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-04
    Dose 1 — Moderna
  2. 2021-01-08
    Registered in v-safe
  3. 2021-01-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Dyspnoea, Fatigue, Feeding disorder, Headache, Injection site pain, Office visit, Pain, SARS-CoV-2 test positive — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Yes- I received the vaccine 1/4. The severe pain at the site lasted 24-hours 48 hours. Chills, body aches, headache and severe fatigue onset within 12 hours of vaccine. I was unable to eat or drink from 1/5-1/7 and was sent to urgent care: tested positive for Covid. On 1/9 my symptoms have improved- able to eat and drink. First time noticing shortness of breath when taking stairs. Resting PO2= 96%.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-09
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  5. 2021-01-11
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-01-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-01-25
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-02-01
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-03
    Dose 2 — Moderna
  10. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  11. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-02-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-02-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-08-04
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  15. 2022-02-05
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-04Moderna
22021-02-03Moderna

Call center

1 call center case

1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Yes- I received the vaccine 1/4. The severe pain at the site lasted 24-hours 48 hours. Chills, body aches, headache and severe fatigue onset within 12 hours of vaccine. I was unable to eat or drink from 1/5-1/7 and was sent to urgent care: tested positive for Covid. On 1/9 my symptoms have improved- able to eat and drink. First time noticing shortness of breath when taking stairs. Resting PO2= 96%.

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

FieldPreferred term2021-092023-042024-11
SROChills ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFeeding disorder ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROOffice visit ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROSARS-CoV-2 test positive ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release