UPS-16252-88378
3 vaccinations
4 coded responses
19 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 087 / NJ
- Registered
- 2021-04-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
65Y-38217-53442
Child or adolescent in my care · Female · 2022-05-12
Timeline
-
2021-04-07
Dose 1 — Moderna
-
2021-04-11
Registered in v-safe
-
2021-04-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-12
-
2021-04-14
Health check-in — day 7, dose 1Feeling: Poor · Site: Pain · Headache, Joint pains, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-21
- 2021-04-28
- 2021-05-07
-
2021-05-12
Dose 2 — Moderna
- 2021-05-12
-
2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Hot flush — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tirednessFree text: Hot flashesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-14
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Chest pain, Injection site pain, Neck pain, Pain in extremity, Tenderness — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body achesFree text: The site pain was very painful yesterday as well as my entire arm -shoulder to wrist. My opposite arm was tender as well for some strange reason. But today only hurts from the elbow up but goes into my chest and into my arm pit. Also sore neck.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-15
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Chest pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Pain in my armpit and into chest on the injection site side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-16
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-16
- 2021-06-23
-
2021-11-17
Dose 3 — Moderna
-
2022-05-12
Survey response — 12 months, dose 2MedDRA: COVID-19, Cough, Dyspnoea, Fatigue, Nasal congestion — Feeling: Fair · Be unable to work or attend school, 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: Covid positive. Shortness of breath. Coughing. Nasal congestion. Fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-05-12
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-05-13
Call successfulDoes not wish to fill out VAERS report
- 2022-05-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-07 | Moderna | |
| 2 | 2021-05-12 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Hot flashes
Systemic reaction (other): The site pain was very painful yesterday as well as my entire arm -shoulder to wrist. My opposite arm was tender as well for some strange reason. But today only hurts from the elbow up but goes into my chest and into my arm pit. Also sore neck.
Systemic reaction (other): Pain in my armpit and into chest on the injection site side.
Release 11 — 12 months, dose 2
Symptoms: Covid positive. Shortness of breath. Coughing. Nasal congestion. Fatigue.
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release