58X-19052-83087
5 vaccinations
6 coded responses
68 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 080 / NJ
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-19
- 2021-03-26
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-06-03
-
2021-09-02
Survey response — 6 months, dose 2MedDRA: Oxygen saturation decreased — Feeling: GoodFree text: Some liw pulse ox levels. No ither ussuesMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-05
Dose 3 — Moderna
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2022-02-04
- 2022-05-06
-
2022-05-11
Dose 4 — Moderna
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-14
- 2022-05-15
- 2022-05-16
-
2022-05-17
Survey response — days 1–6 daily, dose 4MedDRA: Myalgia, Pain — Feeling: Good · Muscle or body achesFree text: The muscle and body aches that I have reported are listed as sude effects for the drug sildenafil that I started taking on May 11 and that could be a cause.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-08-10
-
2022-09-15
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-16
- 2022-09-17
-
2022-09-18
Survey response — days 1–6 daily, dose 5MedDRA: Cough, Throat irritation — Feeling: Fair · Site: ItchingFree text: Slight cough abd scratchy threeMedDRA releases: 2024-11 · check-in free text available
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-29
-
2022-10-06
Survey response — day 21, dose 5MedDRA: Pyrexia, Urinary tract infection — Feeling: GoodFree text: yrinary tract infraction and low frade temperatureMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Survey response — day 28, dose 5MedDRA: Body temperature increased, Urinary tract infection — Feeling: GoodFree text: I have had a urinary tract infection with slight temperature (99.5) that us being treated with antibioticsMedDRA releases: 2024-11 · check-in free text available
- 2022-10-20
-
2022-10-27
Survey response — day 42, dose 5MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: bronchitis which was treated and is now betterMedDRA releases: 2024-11 · check-in free text available
-
2022-10-27
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-10-28
Call successfulDoes not wish to fill out VAERS report
- 2022-12-15
- 2023-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-05-11 | Moderna | No |
| 5 | 2022-09-15 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 9 — 6 months, dose 2
Symptoms: Some liw pulse ox levels. No ither ussues
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The muscle and body aches that I have reported are listed as sude effects for the drug sildenafil that I started taking on May 11 and that could be a cause.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slight cough abd scratchy three
Release 12 — day 21, dose 5
Symptoms: yrinary tract infraction and low frade temperature
Release 12 — day 28, dose 5
Symptoms: I have had a urinary tract infection with slight temperature (99.5) that us being treated with antibiotics
Release 12 — day 42, dose 5
Symptoms: bronchitis which was treated and is now better
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 | Body temperature increased | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Oxygen saturation decreased | ✓ | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Throat irritation | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release