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5RP-71960-58433

2 vaccinations 6 coded responses 16 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
070 / NJ
Registered
2021-01-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-22
    Registered in v-safe
  2. 2021-01-22
    Dose 1 — Moderna
  3. 2021-01-22
    Health check-in — day 0, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  4. 2021-01-23
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dry eye — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Dry eyes
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-24
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Brain fog last two days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  7. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  9. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Muscle or body aches
    Adult check-in
  10. 2021-01-29
    Health check-in — day 7, dose 1
    Feeling: Fair · Muscle or body aches
    Adult check-in
  11. 2021-02-05
    Survey response — day 14, dose 1
    MedDRA: Injection site erythema, Injection site inflammation — Feeling: Good
    Free text: On day 10 post-injection i developed a reddened inflammed patch around injection site. The first day reddened patch was size of 50 cent piece, 3x's that size next 3 days, started subsiding over then the next 3 days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-19
    Dose 2 — Moderna
  13. 2021-02-26
    Health check-in — day 7, dose 2
    Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  14. 2021-03-14
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  15. 2021-03-19
    Survey response — day 28, dose 2
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Aggravation of chronic condition
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-26
    Survey response — day 35, dose 2
    MedDRA: Pain — Feeling: Poor · Be unable to work
    Free text: Worsening of chronic condition.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-02
    Survey response — day 42, dose 2
    MedDRA: Condition aggravated, Pre-existing disease, Reaction to previous exposure to any vaccine, Unevaluable event — Feeling: Poor · Be unable to work
    Free text: Big flare and intensification of chronic inflammatory condition. Unrelenting and worsening since 2nd shot. Began 8 days after shot. Same with 1st shot but not as intense or as long.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-05-21
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  19. 2021-08-22
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-22Moderna
22021-02-19Moderna

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Dry eyes

2021-01-24

Systemic reaction (other): Brain fog last two days

Release 3 — day 14, dose 1

2021-02-05

Symptoms: On day 10 post-injection i developed a reddened inflammed patch around injection site. The first day reddened patch was size of 50 cent piece, 3x's that size next 3 days, started subsiding over then the next 3 days.

Release 5 — day 28, dose 2

2021-03-19

Symptoms: Aggravation of chronic condition

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Worsening of chronic condition.

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Big flare and intensification of chronic inflammatory condition. Unrelenting and worsening since 2nd shot. Began 8 days after shot. Same with 1st shot but not as intense or as long.

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

FieldPreferred term2021-092023-042024-11
SDCondition aggravated ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site inflammation ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDReaction to previous exposure to any vaccine ✓ · ✓
SDUnevaluable event ○ ✓ ○
SRODry eye ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release