5ZT-16719-64842
3 vaccinations
6 coded responses
30 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 070 / NJ
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Moderna
- 2020-12-30
-
2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: The headache was last night from 7:30pm- 10pmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-13
- 2021-01-20
-
2021-01-27
Dose 2 — Moderna
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-24
Survey response — day 28, dose 2MedDRA: Fatigue — Feeling: GoodFree text: TiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-10
- 2021-04-28
- 2021-07-28
-
2021-10-15
Dose 3 — Moderna
- 2021-10-24
- 2021-10-29
-
2021-11-07
Survey response — day 21, dose 3MedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
- 2021-11-14
- 2021-11-20
- 2021-11-26
-
2022-01-14
Survey response — 3 months, dose 3MedDRA: Adverse reaction, Body temperature increased, Exposure to SARS-CoV-2, Headache, Laboratory test abnormal, Nasal pruritus, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: On 12/23/21 I had allergy like symptoms and tested positive on a home rapid test. (My daughter tested positive on a PCR test that was performed on 12-21-21). My symptoms were very mild: low grade fever @99, itchy runny nose, head ache for two days.MedDRA releases: 2024-11 · check-in free text available
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2022-04-15
Survey response — 6 months, dose 3MedDRA: Balance disorder, COVID-19 — Feeling: GoodFree text: It's a mild issue. Since I had COVID in 12-21, my balance has not been as good as it had been. Nothing that gets in my way of daily activities, but when I'm exercising I notice a differenceMedDRA releases: 2024-11 · check-in free text available
-
2022-10-15
Survey response — 12 months, dose 3MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend schoolFree text: Study nose, cough, sore throatMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2021-10-15 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): The headache was last night from 7:30pm- 10pm
Release 4 — day 28, dose 2
Symptoms: Tired
Release 10 — day 21, dose 3
Symptoms: Stuffy nose
Release 10 — 3 months, dose 3
Symptoms: On 12/23/21 I had allergy like symptoms and tested positive on a home rapid test. (My daughter tested positive on a PCR test that was performed on 12-21-21). My symptoms were very mild: low grade fever @99, itchy runny nose, head ache for two days. cut off by CDC
Release 11 — 6 months, dose 3
Symptoms: It's a mild issue. Since I had COVID in 12-21, my balance has not been as good as it had been. Nothing that gets in my way of daily activities, but when I'm exercising I notice a difference
Release 12 — 12 months, dose 3
Symptoms: Study nose, cough, sore throat
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 | Adverse reaction | · | · | ✓ |
| SD | Balance disorder | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasal pruritus | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release