6BA-25268-03517
1 vaccination
8 coded responses
9 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 070 / NJ
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-05
Registered in v-safe
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2021-02-05
Dose 1 — Moderna
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2021-02-05
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
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2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Neck pain — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Chill and pain around the back of my neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea exertional — Feeling: Fair · Site: Pain · Abdominal painFree text: Shortness of breath during little exerciseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Dizziness,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Chills — Feeling: Fair · Fever · Chills, Abdominal pain · Be unable to do your normal daily activitiesFree text: Feel chill from 6- 9 PM. Body temperature in normal range.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — day 7, dose 1MedDRA: Abdominal distension, Flatulence — Feeling: Fair · Site: Pain · Abdominal pain · Be unable to do your normal daily activitiesFree text: Blotting, smelling gas.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Survey response — day 14, dose 1MedDRA: Chills, Fatigue, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Evening chillsFeverishTirednessHave not tested for Corvid - plan to do so next week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-26
Survey response — day 21, dose 1MedDRA: Abdominal pain upper, Dyspnoea, Fatigue, Flatulence, Neck pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Shortness of breath when wearing mask shopping today.Draft like pain on the right side of my neck. Feels feverish but no higher temperature.Occasional stomach pain, smelly gas, and sometimes tired. No COVID-19 test yet.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Survey response — 3 months, dose 1MedDRA: Back pain, Joint stiffness, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Lower back pain, stiff knees and joints; very hard to bend or struggle to wear sucks - all new after vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-06
- 2021-08-11
- 2021-08-16
- 2021-08-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Chill and pain around the back of my neck
Systemic reaction (other): Shortness of breath during little exercise
Systemic reaction (other): Dizziness,
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Feel chill from 6- 9 PM. Body temperature in normal range.
Release 4 — day 7, dose 1
Systemic reaction (other): Blotting, smelling gas.
Release 4 — day 14, dose 1
Symptoms: Evening chillsFeverishTirednessHave not tested for Corvid - plan to do so next week.
Release 4 — day 21, dose 1
Symptoms: Shortness of breath when wearing mask shopping today.Draft like pain on the right side of my neck. Feels feverish but no higher temperature.Occasional stomach pain, smelly gas, and sometimes tired. No COVID-19 test yet.
Release 8 — 3 months, dose 1
Symptoms: Lower back pain, stiff knees and joints; very hard to bend or struggle to wear sucks - all new after vaccination.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspnoea exertional | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release