6BF-13790-93329
4 vaccinations
4 coded responses
27 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 080 / NJ
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-20
- 2021-01-27
-
2021-02-03
Dose 2 — Moderna
-
2021-02-10
Survey response — day 7, dose 2MedDRA: Arthralgia, Chills, Fatigue, Headache — Feeling: Good · Site: Pain, Itching · Be unable to work, Be unable to do your normal daily activitiesFree text: Not today, but the 30 hours post 2nd shot was extreme fatigue, headache, chills, and joint painsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-24
-
2021-03-03
Survey response — day 28, dose 2MedDRA: Fatigue, Headache, Nausea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fatigue, headache, nausea 2/26-28Fine nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
- 2021-03-17
- 2021-05-05
- 2021-08-04
-
2021-11-16
Dose 3 — Moderna
-
2022-02-03
Survey response — 12 months, dose 2MedDRA: COVID-19, Fatigue, Influenza, Malaise, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I had the flu or Covid in December Not hospitalized, but sick for 7 days. Negative COVID test, but had all the symptoms. It has taken weeks and I still experience fatigue But, thankful I'd had received the boosterMedDRA releases: 2024-11 · check-in free text available
-
2022-02-03
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-09
Call successfulDoes not wish to fill out VAERS report
-
2022-04-12
Dose 4 — Moderna
- 2022-04-27
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
-
2022-07-12
Survey response — 3 months, dose 4MedDRA: Chest pain, Dizziness, Emergency care, Headache, Hypotension, Nausea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Headache, Chest pain, nausea, lightheaded low BP In EDMedDRA releases: 2024-11 · check-in free text available
-
2022-07-12
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-07-13
- 2022-10-11
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-11-16 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 4 — day 7, dose 2
Systemic reaction (other): Not today, but the 30 hours post 2nd shot was extreme fatigue, headache, chills, and joint pains
Release 5 — day 28, dose 2
Symptoms: Fatigue, headache, nausea 2/26-28Fine now
Release 11 — 12 months, dose 2
Symptoms: I had the flu or Covid in December Not hospitalized, but sick for 7 days. Negative COVID test, but had all the symptoms. It has taken weeks and I still experience fatigue But, thankful I'd had received the booster
Release 12 — 3 months, dose 4
Symptoms: Headache, Chest pain, nausea, lightheaded low BP In ED
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 | Chest pain | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypotension | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release