PN8-51352-28094
3 vaccinations
1 coded response
6 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 070 / NJ
- Registered
- 2021-06-14
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
98V-27079-60145
Adult relative or friend · Female · 2021-06-14
Timeline
-
2021-04-09
Dose 1 — Moderna
-
2021-05-07
Dose 2 — Moderna
-
2021-06-14
Registered in v-safe
- 2021-06-14
-
2021-12-22
Dose 3 — Moderna
- 2021-12-22
-
2021-12-23
Survey response — days 1–6 daily, dose 3MedDRA: Pain — Feeling: Fair · Headache, Muscle or body achesFree text: Just a mild pain,MedDRA releases: 2024-11 · check-in free text available
- 2021-12-24
- 2021-12-25
- 2021-12-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Moderna | |
| 2 | 2021-05-07 | Moderna | |
| 3 | 2021-12-22 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Just a mild pain,
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 |
|---|---|---|---|---|
| SRO | Pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release