7CU-27697-63857
3 vaccinations
2 coded responses
2 check-ins
2 free-text entries
0 call cases
- Sex
- —
- Age at first dose
- 36-40
- ZIP prefix
- 028 / RI
- Registered
- 2022-04-09
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-02-14
Dose 1 — Moderna
-
2022-03-04
Dose 2 — Pfizer-BioNTech
-
2022-04-09
Registered in v-safe
-
2022-04-09
Dose 3 — Janssen/Johnson & Johnson
-
2022-04-09
Survey response — day 0, dose 3MedDRA: Aphasia — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection siteFree text: i cant talkMedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — day 35, dose 2MedDRA: Unevaluable event — Feeling: PoorFree text: im dyingMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-14 | Moderna | No |
| 2 | 2022-03-04 | Pfizer-BioNTech | No |
| 3 | 2022-04-09 | Janssen/Johnson & Johnson | No |
Free text
Release 11 — day 0, dose 3
Systemic reaction (other): i cant talk
Release 11 — day 35, dose 2
Symptoms: im dying
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 | Unevaluable event | · | · | ✓ |
| SRO | Aphasia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release