6XH-96251-37977
2 vaccinations
6 coded responses
23 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 087 / NJ
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
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2021-03-17
Dose 1 — Moderna
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2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, NauseaAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea · Be unable to workFree text: Mild DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Pain, Swelling · Rash, not including the immediate area around the injection siteFree text: A good effect: A general clearing of severe eczema that pre-existed the second dose of vaccine. This general clearing also occurred while I was infected with COVID-19 and lasted a few weeks. A new rash has appeared across my chest and neck since receiving the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal discomfort, Decreased appetite — Feeling: Good · Site: PainFree text: Lack of appetite. Slightly sensitive stomach. Only interested in creamy foods and mild soups.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-18
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2021-04-21
Survey response — day 7, dose 2MedDRA: Adverse reaction — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Nausea, Vomiting · Be unable to workFree text: I couldnt submit my data for two days because the site was down. This information is for the period between Monday and Tuesdays report.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — day 14, dose 2MedDRA: Fatigue, Irritability, Parosmia — Feeling: GoodFree text: Fatigue, irritability, chemical smell that I initially thought was skunk but it seems to be something only I can smell.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
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2021-07-14
Survey response — 3 months, dose 2MedDRA: Photopsia, Vitreous floaters — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Just recently Ive had flashing lights in my right eye and some mild floaters. Its been happening for three days. Not sure if its related but thought it best to mention it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-14
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
- 2021-10-14
- 2022-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Mild Dizziness
Systemic reaction (other): A good effect: A general clearing of severe eczema that pre-existed the second dose of vaccine. This general clearing also occurred while I was infected with COVID-19 and lasted a few weeks. A new rash has appeared across my chest and neck since receiving the shot.
Systemic reaction (other): Lack of appetite. Slightly sensitive stomach. Only interested in creamy foods and mild soups.
Release 7 — day 7, dose 2
Systemic reaction (other): I couldnt submit my data for two days because the site was down. This information is for the period between Monday and Tuesdays report.
Release 8 — day 14, dose 2
Symptoms: Fatigue, irritability, chemical smell that I initially thought was skunk but it seems to be something only I can smell.
Release 9 — 3 months, dose 2
Symptoms: Just recently Ive had flashing lights in my right eye and some mild floaters. Its been happening for three days. Not sure if its related but thought it best to mention it.
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 | Fatigue | ✓ | ✓ | ✓ |
| SD | Irritability | ✓ | ✓ | ✓ |
| SD | Parosmia | ✓ | ✓ | ✓ |
| SD | Photopsia | ✓ | ✓ | ✓ |
| SD | Vitreous floaters | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release