5J9-45161-59203
5 vaccinations
5 coded responses
36 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 323 / FL
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
-
2021-01-16
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: GoodFree text: Circa Jan. 11, nine days after I got the vaccine, the area of the shot became a bit raised, red, warm, and itchy for 3-4 days. It didn't affect function. Fine now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-30
-
2021-02-02
Dose 2 — Moderna
- 2021-02-02
-
2021-02-03
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Last night, about 14 hours after my shot, when I was in bed, I was shivering and my teeth were chattering. I toughed it out.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased — Feeling: Good · Site: Pain · ChillsFree text: Yesterday afternoon my temp got up to 100.8 but today is back to 97. I'm reporting for the last 24 hours, not just the 14 hours today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2021-08-08
Dose 3 — Moderna
- 2021-11-07
- 2022-02-06
-
2022-07-02
Dose 4 — Pfizer-BioNTech
- 2022-07-26
- 2022-07-30
- 2022-08-06
- 2022-08-13
-
2022-10-01
Survey response — 3 months, dose 4MedDRA: COVID-19, Conjunctival haemorrhage, Hypertension — Feeling: Good · Be unable to do your normal daily activitiesFree text: Morbid hypertension. No htn before. Had a bad bout of Covid-19 after attending a reunion in late April 2022. I blame that. Had a subconjunctival hemorrhage, checked BP and it was over 180. On meds, now controlled. Had Covid-19 x 2 this year.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-18
Dose 5 — Moderna
- 2022-12-31
-
2022-12-31
Survey response — 6 months, dose 4MedDRA: COVID-19, Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: After a bout of Covid-19, I developed morbid hypertension and now I'm on two medications for that. My BP was over 180 and I burst blood vessels in my eye.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-31
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2023-01-04
Call successfulDoes not wish to fill out VAERS report
- 2023-02-17
- 2023-05-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-08-08 | Moderna | No |
| 4 | 2022-07-02 | Pfizer-BioNTech | No |
| 5 | 2022-11-18 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 2 — day 14, dose 1
Symptoms: Circa Jan. 11, nine days after I got the vaccine, the area of the shot became a bit raised, red, warm, and itchy for 3-4 days. It didn't affect function. Fine now.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Last night, about 14 hours after my shot, when I was in bed, I was shivering and my teeth were chattering. I toughed it out.
Systemic reaction (other): Yesterday afternoon my temp got up to 100.8 but today is back to 97. I'm reporting for the last 24 hours, not just the 14 hours today.
Release 12 — 3 months, dose 4
Symptoms: Morbid hypertension. No htn before. Had a bad bout of Covid-19 after attending a reunion in late April 2022. I blame that. Had a subconjunctival hemorrhage, checked BP and it was over 180. On meds, now controlled. Had Covid-19 x 2 this year.
Release 12 — 6 months, dose 4
Symptoms: After a bout of Covid-19, I developed morbid hypertension and now I'm on two medications for that. My BP was over 180 and I burst blood vessels in my eye.
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 | Conjunctival haemorrhage | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release