6L3-18732-90158
5 vaccinations
5 coded responses
63 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 076 / NJ
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Insomnia, Palpitations, Tachycardia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: palpitations (tachycardia) overnight, which caused me to lose lots of sleep (likely cause of today's fatigue or tiredness)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: The pain at the injection site is barely noticeable today, and is hardly worth mentioning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-26
- 2021-05-12
- 2021-08-11
-
2021-11-16
Dose 3 — Moderna
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-02-15
-
2022-05-07
Dose 4 — Moderna
- 2022-05-07
-
2022-05-08
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-05-09
-
2022-05-10
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: The pain at the injection site is so mild today that I feel it only when there's pressure on that spot.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-06-04
-
2022-06-11
Survey response — day 35, dose 4MedDRA: Chills, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throat for four days, beginning evening of 06/06/2022; also mild chills and fever symptoms for about 24 hours beginning evening of 06/06/2022. Rapid antigen test AM 06/07/2022 was positive for coronavirus. Doctor prescribed Paxlovid.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-11
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-06-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-18
- 2022-08-06
-
2022-09-29
Dose 5 — Moderna
- 2022-09-29
-
2022-09-30
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-13
- 2022-10-20
-
2022-10-27
Survey response — day 28, dose 5MedDRA: Nasal congestion, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: GoodFree text: Very mild cold symptoms (slight sore throat and slight nasal congestion) on 10/26/2022, mostly resolved 10/27/2022. Rapid antigen test for COVID-19 on evening of 10/26 was negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-03
- 2022-11-10
- 2022-12-29
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-11-16 | Moderna | No |
| 4 | 2022-05-07 | Moderna | No |
| 5 | 2022-09-29 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): palpitations (tachycardia) overnight, which caused me to lose lots of sleep (likely cause of today's fatigue or tiredness)
Systemic reaction (other): The pain at the injection site is barely noticeable today, and is hardly worth mentioning.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The pain at the injection site is so mild today that I feel it only when there's pressure on that spot.
Release 12 — day 35, dose 4
Symptoms: Sore throat for four days, beginning evening of 06/06/2022; also mild chills and fever symptoms for about 24 hours beginning evening of 06/06/2022. Rapid antigen test AM 06/07/2022 was positive for coronavirus. Doctor prescribed Paxlovid.
Release 12 — day 28, dose 5
Symptoms: Very mild cold symptoms (slight sore throat and slight nasal congestion) on 10/26/2022, mostly resolved 10/27/2022. Rapid antigen test for COVID-19 on evening of 10/26 was negative.
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 | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release