5SS-89016-15828
5 vaccinations
6 coded responses
22 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 085 / NJ
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
DLX-23287-40707
Other · Male · 2021-06-21
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-03-25
Dose 2 — Moderna
-
2021-03-28
Registered in v-safe
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2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fever · Chills, Fatigue or tirednessAdult check-in
-
2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Pain, Pyrexia, Self-medication — Feeling: Good · Fever · Muscle or body aches, Fatigue or tirednessFree text: Got 2nd shot 3/25, at night was aching all over. 3/26 AM took Advil, took long nap. After dinner, pain came back, took another Advil. 3/27 felt weak feverish, took Advil twice. 3/28 better. 3/29 almost back to normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fever · Fatigue or tirednessAdult check-in
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: Itching · Fever · Fatigue or tirednessFree text: After a short nap is much better than yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — day 7, dose 2MedDRA: Dizziness — Feeling: Fair · Fever · Joint pains, Fatigue or tirednessFree text: Some dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-08
Survey response — day 14, dose 2MedDRA: Chills, Pyrexia, Self-medication — Feeling: FairFree text: Chill, iciness ,low grade fever, took AdvilMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-22
- 2021-04-29
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2021-05-06
Survey response — day 42, dose 2MedDRA: Office visit, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Sinus infection, take antibiotics. This is the fifth day of taking medication.@ · Healthcare visit (other): During my check up with pulmonologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-24
- 2021-09-23
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2021-10-23
Dose 3 — Moderna
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2021-10-30
Survey response — day 7, dose 3MedDRA: Arthralgia, Discomfort, Myalgia, Pyrexia — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tirednessFree text: It seems a bit late to receive these questionnaire. My booster shot was 10/23 . 10/24,25,26 were not comfortable. Fever, muscle and joints aching.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-06
- 2021-11-13
- 2021-11-22
- 2021-11-27
- 2021-12-04
- 2022-01-22
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2022-04-18
Dose 4 — Moderna
- 2022-04-23
- 2022-05-06
- 2022-05-18
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2022-09-19
Dose 5 — Moderna
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
| 5 | 2022-09-19 | Moderna | No |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Got 2nd shot 3/25, at night was aching all over. 3/26 AM took Advil, took long nap. After dinner, pain came back, took another Advil. 3/27 felt weak feverish, took Advil twice. 3/28 better. 3/29 almost back to normal.
Systemic reaction (other): After a short nap is much better than yesterday
Release 6 — day 7, dose 2
Systemic reaction (other): Some dizziness
Release 7 — day 14, dose 2
Symptoms: Chill, iciness ,low grade fever, took Advil
Release 8 — day 42, dose 2
Symptoms: Sinus infection, take antibiotics. This is the fifth day of taking medication.@
Healthcare visit (other): During my check up with pulmonologist
Release 10 — day 7, dose 3
Systemic reaction (other): It seems a bit late to receive these questionnaire. My booster shot was 10/23 . 10/24,25,26 were not comfortable. Fever, muscle and joints aching.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Discomfort | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release