4F8-26091-86613
5 vaccinations
5 coded responses
50 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 070 / NJ
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 1 — Moderna
- 2021-03-19
-
2021-03-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Alopecia, Fatigue, SARS-CoV-2 test positive — Feeling: GoodFree text: FYI In December I tested positive for COVID the only lingering effects hair loss and more easily tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Amnesia, Fatigue, Stress — Feeling: GoodFree text: On 3/20/21 day following my vaccination I was feeling very fatigued I had a weird memory loss never experienced before I assume it is due to the stress of my body reaction .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Dose 2 — Moderna
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
-
2021-07-16
Survey response — 3 months, dose 2MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: GoodFree text: Occasional sore throat and runny noseMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-10-15
-
2021-10-16
Dose 3 — Moderna
-
2021-10-30
Survey response — day 14, dose 3MedDRA: Back pain, Diarrhoea, Fatigue, Headache, Injection site pain, Pain in extremity, Rash, Rash erythematous, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Vomiting diarrhea red rash armpit of opposite arm receiving vaccine headache slight soreness at injection site fatigue back and thigh painMedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — day 21, dose 3MedDRA: Urticaria — Feeling: GoodFree text: I have been breaking out in hives on my neck arms primarilyMedDRA releases: 2024-11 · check-in free text available
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2022-01-15
-
2022-04-14
Dose 4 — Moderna
- 2022-04-16
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-07-14
-
2022-10-04
Dose 5 — Pfizer-BioNTech
- 2022-10-13
- 2022-10-23
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2023-01-03
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-16 | Moderna | |
| 3 | 2021-10-16 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
| 5 | 2022-10-04 | Pfizer-BioNTech | No |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): FYI In December I tested positive for COVID the only lingering effects hair loss and more easily tired
Systemic reaction (other): On 3/20/21 day following my vaccination I was feeling very fatigued I had a weird memory loss never experienced before I assume it is due to the stress of my body reaction .
Release 9 — 3 months, dose 2
Symptoms: Occasional sore throat and runny nose
Release 10 — day 14, dose 3
Symptoms: Vomiting diarrhea red rash armpit of opposite arm receiving vaccine headache slight soreness at injection site fatigue back and thigh pain
Release 10 — day 21, dose 3
Symptoms: I have been breaking out in hives on my neck arms primarily
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 | Back pain | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Alopecia | ✓ | ✓ | ✓ |
| SRO | Amnesia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
| SRO | Stress | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release