4H2-27594-65424
2 vaccinations
6 coded responses
19 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 073 / NJ
- Registered
- 2021-02-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-15
Dose 1 — Moderna
-
2021-02-22
Registered in v-safe
- 2021-02-22
- 2021-03-01
- 2021-03-10
-
2021-03-15
Dose 2 — Moderna
- 2021-03-15
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Just kind of woozy-Decided I should not drive this morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Tremor — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: A bit shaky in the morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
-
2021-03-20
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Woke up feeling woozy again today. Felt great yesterday, but did have 1 glass of wine last night. It was truly one glass, so I am definitely not hungover. Did the wine have an affect though? I do not know, just felt like Ibwas set back a day, after feeling great yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-21
- 2021-03-22
-
2021-03-29
Survey response — day 14, dose 2MedDRA: Fatigue, Pyrexia — Feeling: GoodFree text: I have had 3 glasses of wine since the vaccination, with dinner in 3 separate occasions. Of the three times, twice I woke up the next morning feeling as though I had been through the fever all over again, exhausted and totally worn out.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-06-14
-
2021-09-15
Survey response — 6 months, dose 2MedDRA: Asthma, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Asthma flare up. First in yearsMedDRA releases: 2024-11 · check-in free text available
-
2021-09-15
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-20
Call successfulDoes not wish to fill out VAERS report
-
2022-03-17
Survey response — 12 months, dose 2MedDRA: Fatigue, Headache — Feeling: Good · Be unable to work or attend school, 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: Several days of bad headaches, feeling exhausted.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-17
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-18
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Just kind of woozy-Decided I should not drive this morning.
Systemic reaction (other): A bit shaky in the morning
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Woke up feeling woozy again today. Felt great yesterday, but did have 1 glass of wine last night. It was truly one glass, so I am definitely not hungover. Did the wine have an affect though? I do not know, just felt like Ibwas set back a day, after feeling great yesterday.
Release 6 — day 14, dose 2
Symptoms: I have had 3 glasses of wine since the vaccination, with dinner in 3 separate occasions. Of the three times, twice I woke up the next morning feeling as though I had been through the fever all over again, exhausted and totally worn out.
Release 9 — 6 months, dose 2
Symptoms: Asthma flare up. First in years
Release 11 — 12 months, dose 2
Symptoms: Several days of bad headaches, feeling exhausted.
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 | Asthma | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release