6K4-14234-22416
2 vaccinations
2 coded responses
26 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 070 / NJ
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
-
2020-12-30
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: The night of injection 1, I felt very tired. When I woke up this morning I felt normal again.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-03
- 2021-03-08
- 2021-04-26
- 2021-07-26
-
2022-01-25
Survey response — 12 months, dose 2MedDRA: COVID-19, Office visit — 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 professionalFree text: Symptoms: Covid 19 virus · Healthcare visit (other): Doctor's office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
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 pr1 call case(s)
-
2022-01-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-25 | Successful 2022-01-27 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): The night of injection 1, I felt very tired. When I woke up this morning I felt normal again.
Release 11 — 12 months, dose 2
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 | COVID-19 | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release