64A-19137-02107
5 vaccinations
10 coded responses
54 check-ins
10 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 080 / NJ
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
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2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Decreased appetite, Gastrooesophageal reflux disease — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: No appetite, GERD symptoms severeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body achesFree text: I feel like I felt when I tested + Covid 12/2/20MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Gastrooesophageal reflux disease — Feeling: GoodFree text: My extreme GERD has finally resolved.It lasted 3 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
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2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, NauseaAdult check-in
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
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2021-03-09
Survey response — day 21, dose 2MedDRA: Constipation, Dry eye, Vulvovaginal dryness — Feeling: GoodFree text: Increased dryness eyes , vaginally, constipation This has been going on since I had Covid . Decided it has to do with the virusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — day 28, dose 2MedDRA: Disturbance in attention, Ear pain, Fatigue, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Today I am tired , achy, sore throat, ear ache, difficulty concentratingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-19
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2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · None · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
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2021-12-09
Survey response — day 42, dose 3MedDRA: Fatigue, Headache, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: FairFree text: Headache, runny nose , tired . Had a rapid negative CoVid test yesterdayMedDRA releases: 2024-11 · check-in free text available
- 2022-01-27
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2022-04-25
Dose 4 — Moderna
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2022-04-28
Survey response — 6 months, dose 3MedDRA: Chills, Fatigue, Pyrexia — Feeling: GoodFree text: 36 hrs post boosters fever chills fatigueMedDRA releases: 2024-11 · check-in free text available
- 2022-05-19
- 2022-05-23
- 2022-05-30
- 2022-06-07
- 2022-07-25
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2022-09-19
Dose 5 — Moderna
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2022-09-23
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Joint pains, Muscle or body aches, NauseaAdult check-in
- 2022-09-24
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2022-09-25
Survey response — days 1–6 daily, dose 5MedDRA: Ear pain — Feeling: GoodFree text: Ear acheMedDRA releases: 2024-11 · check-in free text available
- 2022-09-26
- 2022-10-03
- 2022-10-10
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2022-10-17
Survey response — day 28, dose 5MedDRA: Chills, Headache, Listless — Feeling: FairFree text: Headache, chills, listlessMedDRA releases: 2024-11 · check-in free text available
- 2022-10-24
- 2022-10-31
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2022-12-19
Survey response — 3 months, dose 5MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I had CoVid 11/28-12/2/2022MedDRA releases: 2024-11 · check-in free text available
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-25 | Moderna | No |
| 5 | 2022-09-19 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): No appetite, GERD symptoms severe
Systemic reaction (other): I feel like I felt when I tested + Covid 12/2/20
Systemic reaction (other): My extreme GERD has finally resolved.It lasted 3 days
Release 5 — day 21, dose 2
Symptoms: Increased dryness eyes , vaginally, constipation This has been going on since I had Covid . Decided it has to do with the virus
Release 5 — day 28, dose 2
Symptoms: Today I am tired , achy, sore throat, ear ache, difficulty concentrating
Release 10 — day 42, dose 3
Symptoms: Headache, runny nose , tired . Had a rapid negative CoVid test yesterday
Release 11 — 6 months, dose 3
Symptoms: 36 hrs post boosters fever chills fatigue
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Ear ache
Release 12 — day 28, dose 5
Symptoms: Headache, chills, listless
Release 12 — 3 months, dose 5
Symptoms: I had CoVid 11/28-12/2/2022
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 | Chills | · | · | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Disturbance in attention | ✓ | ✓ | ✓ |
| SD | Dry eye | ✓ | ✓ | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Listless | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vulvovaginal dryness | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release