ADJ-31040-00537
4 vaccinations
1 coded response
43 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 073 / NJ
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
RTL-25009-76206
Child or adolescent in my care · Female · 2022-06-27
Timeline
-
2021-03-18
Registered in v-safe
-
2021-03-18
Dose 1 — Pfizer-BioNTech
- 2021-03-18
- 2021-03-19
-
2021-03-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, NauseaAdult check-in
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Muscle or body achesAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-01
-
2021-04-08
Dose 2 — Pfizer-BioNTech
- 2021-04-08
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-07-08
- 2021-10-07
-
2021-12-08
Dose 3 — Moderna
- 2021-12-21
- 2021-12-22
- 2021-12-29
- 2022-01-05
- 2022-01-12
- 2022-01-19
-
2022-03-09
Survey response — 3 months, dose 3MedDRA: COVID-19, Influenza like illness — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Had flu like COVID in late JanuaryMedDRA releases: 2024-11 · check-in free text available
-
2022-03-09
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-11
Call successfulDoes not wish to fill out VAERS report
- 2022-06-08
-
2022-09-07
Dose 4 — Moderna
- 2022-09-11
- 2022-09-12
- 2022-09-13
- 2022-09-14
- 2022-09-21
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-12-07
- 2023-03-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Pfizer-BioNTech | |
| 2 | 2021-04-08 | Pfizer-BioNTech | |
| 3 | 2021-12-08 | Moderna | No |
| 4 | 2022-09-07 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 11 — 3 months, dose 3
Symptoms: Had flu like COVID in late January
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 | COVID-19 | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release