6BJ-12171-17804
5 vaccinations
14 coded responses
52 check-ins
14 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 112 / NY
- Registered
- 2021-07-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-08
Dose 1 — Moderna
-
2021-07-06
Registered in v-safe
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2021-07-06
Dose 2 — Moderna
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2021-07-06
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-07
Survey response — days 1–6 daily, dose 2MedDRA: Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Very sleepyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-08
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-09
- 2021-07-10
- 2021-07-11
- 2021-07-12
- 2021-07-13
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2021-07-20
Survey response — day 14, dose 2MedDRA: Fatigue, Somnolence — Feeling: Good · Be unable to do your normal daily activitiesFree text: Very tired and sleepy for about 4 days but fine nowMedDRA releases: 2024-11 · check-in free text available
- 2021-07-27
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2021-08-03
Survey response — day 28, dose 2MedDRA: Asthenia, Chills, Feeling cold, Hyperhidrosis, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bad shivering, felt cold and had no control over shivers on Saturday night then sweats early Sunday morning, feeling very weak & body aches. Stayed in bed most of day. Am considering a covid test even though I have not been out.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-10
Survey response — day 35, dose 2MedDRA: Asthenia, Chills, Fatigue, Nausea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Still feeling very weak and tired. Random shivering and nauseous.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-17
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2021-10-05
Survey response — 3 months, dose 2MedDRA: Headache, Vision blurred — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Severe headache, blurred vision, better nowMedDRA releases: 2024-11 · check-in free text available
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2021-10-05
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-10-06
- 2022-01-06
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2022-01-09
Dose 3 — Moderna
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2022-01-11
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: I have pain under left arm and left side of left breast, same side as injection site (left arm). Pain since receiving injection on Sunday, 1/9/2022.MedDRA releases: 2024-11 · check-in free text available
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2022-01-13
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain, ItchingFree text: Underarm and left side of left breast pain but is subsidingMedDRA releases: 2024-11 · check-in free text available
- 2022-01-14
- 2022-01-16
- 2022-01-23
- 2022-01-30
- 2022-02-06
- 2022-02-13
- 2022-02-20
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2022-04-11
Survey response — 3 months, dose 3MedDRA: Arthralgia, Chest pain, Headache, Neck pain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Had chest pain when taking deep breath. Neck pain across shoulders with headaches which lasted for one week. Had neurologist appointment but could not go. I did go to my doctor. · Healthcare visit (other): Went to my doctor. She did an EKG. All was ok.MedDRA releases: 2024-11 · check-in free text available
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2022-04-11
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-13
- 2022-07-12
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2022-07-24
Dose 4 — Moderna
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2022-07-26
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tirednessFree text: Pain in armpit of injection site (left arm) and left breastMedDRA releases: 2024-11 · check-in free text available
- 2022-07-27
- 2022-07-28
- 2022-07-29
- 2022-07-30
- 2022-07-31
- 2022-08-07
- 2022-08-14
- 2022-08-21
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2022-08-28
Survey response — day 35, dose 4MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Continuous back pain for past 2 weeksMedDRA releases: 2024-11 · check-in free text available
- 2022-09-04
- 2022-10-23
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2022-12-04
Dose 5 — Moderna
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2022-12-05
Survey response — days 1–6 daily, dose 5MedDRA: Axillary pain, Breast pain, Chills, Night sweats, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Chills & feverish (sweating) during the night; pain under arm and left breast.MedDRA releases: 2024-11 · check-in free text available
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2022-12-06
Survey response — days 1–6 daily, dose 5MedDRA: Axillary pain — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Pain under arm of injection sightMedDRA releases: 2024-11 · check-in free text available
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2022-12-07
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · HeadacheAdult check-in
- 2022-12-08
- 2022-12-09
- 2022-12-10
- 2022-12-11
- 2022-12-18
- 2022-12-25
- 2023-01-01
- 2023-01-08
- 2023-01-15
- 2023-03-05
- 2023-06-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-08 | Moderna | No |
| 2 | 2021-07-06 | Moderna | No |
| 3 | 2022-01-09 | Moderna | No |
| 4 | 2022-07-24 | Moderna | No |
| 5 | 2022-12-04 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 9 — day 0, dose 2
Systemic reaction (other): None
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Very sleepy
Systemic reaction (other): None
Release 9 — day 14, dose 2
Symptoms: Very tired and sleepy for about 4 days but fine now
Release 9 — day 28, dose 2
Symptoms: Bad shivering, felt cold and had no control over shivers on Saturday night then sweats early Sunday morning, feeling very weak & body aches. Stayed in bed most of day. Am considering a covid test even though I have not been out.
Release 9 — day 35, dose 2
Symptoms: Still feeling very weak and tired. Random shivering and nauseous.
Release 10 — 3 months, dose 2
Symptoms: Severe headache, blurred vision, better now
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have pain under left arm and left side of left breast, same side as injection site (left arm). Pain since receiving injection on Sunday, 1/9/2022.
Systemic reaction (other): Underarm and left side of left breast pain but is subsiding
Release 11 — 3 months, dose 3
Symptoms: Had chest pain when taking deep breath. Neck pain across shoulders with headaches which lasted for one week. Had neurologist appointment but could not go. I did go to my doctor.
Healthcare visit (other): Went to my doctor. She did an EKG. All was ok.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Pain in armpit of injection site (left arm) and left breast
Release 12 — day 35, dose 4
Symptoms: Continuous back pain for past 2 weeks
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Chills & feverish (sweating) during the night; pain under arm and left breast.
Systemic reaction (other): Pain under arm of injection sight
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 | Arthralgia | · | · | ✓ |
| SD | Asthenia | ✓ | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Chills | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Feeling cold | ✓ | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hyperhidrosis | ✓ | · | ✓ |
| SD | Nausea | ✓ | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Vision blurred | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Breast pain | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Night sweats | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release