57G-27826-23818
2 vaccinations
4 coded responses
18 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 073 / NJ
- Registered
- 2021-08-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JNK-11231-73677
Adult relative or friend · Female · 2021-08-22
Timeline
-
2021-08-19
Registered in v-safe
-
2021-08-19
Dose 1 — Moderna
- 2021-08-19
-
2021-08-20
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: I only had pain in my arms muscle.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-21
- 2021-08-22
- 2021-08-23
- 2021-08-25
- 2021-08-26
-
2021-09-02
Survey response — day 14, dose 1MedDRA: Headache, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: 8 days after the shot, I developed a lasting headache. I have had this headache for approx. a week already, and I am going to see a doctor tomorrow. I did not have a headache that lasted more than one day prior to this situation. · Healthcare visit (other): In office visitMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-02
Report sent to call center — day 14, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-08
- 2021-09-09
- 2021-09-16
- 2021-09-23
-
2021-09-27
Dose 2 — Moderna
-
2021-09-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-10-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-10-04
Survey response — day 7, dose 2MedDRA: Thrombosis — Feeling: GoodFree text: Blood clot on my lip, maybe not related to the vaccineMedDRA releases: 2024-11 · check-in free text available
- 2021-10-11
- 2021-12-27
-
2022-03-28
Survey response — 6 months, dose 2MedDRA: Axillary pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I got a Pfizer booster shot on March 27, 2022, and on March 28, 2022, I had pain in the armpit of the hand in which I received the shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-19 | Moderna | No |
| 2 | 2021-09-27 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): I only had pain in my arms muscle.
Release 9 — day 14, dose 1
Symptoms: 8 days after the shot, I developed a lasting headache. I have had this headache for approx. a week already, and I am going to see a doctor tomorrow. I did not have a headache that lasted more than one day prior to this situation.
Healthcare visit (other): In office visit
Release 9 — day 7, dose 2
Systemic reaction (other): Blood clot on my lip, maybe not related to the vaccine
Release 11 — 6 months, dose 2
Symptoms: I got a Pfizer booster shot on March 27, 2022, and on March 28, 2022, I had pain in the armpit of the hand in which I received the shot.
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 | Axillary pain | · | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SRO | Myalgia | ✓ | · | ✓ |
| SRO | Thrombosis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release