EZG-14900-45881
4 vaccinations
5 coded responses
35 check-ins
5 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 071 / NJ
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-01
- 2021-02-06
- 2021-02-13
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
-
2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: Chills were during the night. No longer experiencing them. Just very tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
-
2021-05-22
Survey response — 3 months, dose 2MedDRA: Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Nothing to do with covid. Had had surgery today gall bladder removed o with covid. NnMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-22
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-21
Survey response — 6 months, dose 2MedDRA: Atrial fibrillation, Emergency care, Gallbladder operation, Post procedural complication — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Gall bladder er surgeryAfib triggered by surgeryMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-21
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-24
-
2021-11-05
Dose 3 — Moderna
-
2022-02-22
Survey response — 12 months, dose 2MedDRA: Surgery, Uterine cancer, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Just had a hysteroscopy and d and c and diagnosed with stage one uterine cancer · Healthcare visit (other): Doctors office/same day surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-02-22
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-23
-
2022-04-22
Dose 4 — Moderna
-
2022-04-29
Survey response — day 7, dose 4MedDRA: SARS-CoV-2 test positive — Feeling: Fair · None · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Tested positive for Covid days after boosterMedDRA releases: 2024-11 · check-in free text available
-
2022-04-29
Report sent to call center — day 7, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-03
- 2022-05-12
- 2022-05-13
- 2022-05-22
- 2022-05-27
- 2022-06-03
- 2022-07-22
- 2022-10-23
- 2023-04-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-22 | Unsuccessful | |
| 2021-08-21 | Unsuccessful | |
| 2022-02-22 | Unsuccessful | |
| 2022-04-29 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Chills were during the night. No longer experiencing them. Just very tired
Release 8 — 3 months, dose 2
Symptoms: Nothing to do with covid. Had had surgery today gall bladder removed o with covid. Nn
Release 9 — 6 months, dose 2
Symptoms: Gall bladder er surgeryAfib triggered by surgery
Release 11 — 12 months, dose 2
Symptoms: Just had a hysteroscopy and d and c and diagnosed with stage one uterine cancer
Healthcare visit (other): Doctors office/same day surgery
Release 11 — day 7, dose 4
Healthcare visit (other): Tested positive for Covid days after booster
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 | SARS-CoV-2 test positive | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Atrial fibrillation | ✓ | · | ✓ |
| SD | Emergency care | ✓ | · | ✓ |
| SD | Gallbladder operation | ✓ | · | ✓ |
| SD | Post procedural complication | ✓ | · | ✓ |
| SD | Surgery | ✓ | ✓ | ✓ |
| SD | Uterine cancer | · | · | ✓ |
| SD | Uterine dilation and curettage | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release