Y56-17908-81372
4 vaccinations
6 coded responses
32 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 074 / NJ
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
-
2021-01-26
Dose 1 — Moderna
-
2021-01-26
Survey response — day 0, dose 1MedDRA: Ear pain, Oropharyngeal pain — Feeling: Fair · HeadacheFree text: Sore throat, ear acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Ear pain, Headache, Oropharyngeal pain — Feeling: Good · Site: PainFree text: On 1-26-2021 at 8 pm I had an intense headache, sore throat and earache which lasted about 2 hours. I went to sleep and felt fine in the morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-18
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Ear pain, Oropharyngeal pain — Feeling: Good · Site: Pain · HeadacheFree text: Ear ache, sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Cough, Dizziness, Headache, Impaired work ability, Influenza, Influenza virus test negative, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test, SARS-CoV-2 test negative — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Severe flu symptoms, very sore throat, head/chest congested, dizzy, cough, headache. Test neg for covid 19, variants and flu. Missed work. Now a week later, lingering cough & chest congest. Back at work (tchr) wearing mask while still have a cough. · Healthcare visit (other): Drive through testing facilityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-16
Dose 3 — Moderna
-
2021-08-24
Survey response — 6 months, dose 2MedDRA: Cough, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · 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: Cough, fever, sore throat. Had a covid test . . It can back negative for covid 19 and varients.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-24
Report sent to call center — 6 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 pr1 call case(s)
- 2021-08-26
- 2022-02-23
-
2022-04-09
Dose 4 — Pfizer-BioNTech
- 2022-04-28
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-07-11
-
2022-10-08
Survey response — 6 months, dose 4MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: GoodFree text: Cold, cough, sore throat, congestion.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-08-16 | Moderna | No |
| 4 | 2022-04-09 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-26 | Unsuccessful | |
| 2021-08-24 | Unsuccessful |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Sore throat, ear ache
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): On 1-26-2021 at 8 pm I had an intense headache, sore throat and earache which lasted about 2 hours. I went to sleep and felt fine in the morning.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Ear ache, sore throat
Release 8 — 3 months, dose 2
Symptoms: Severe flu symptoms, very sore throat, head/chest congested, dizzy, cough, headache. Test neg for covid 19, variants and flu. Missed work. Now a week later, lingering cough & chest congest. Back at work (tchr) wearing mask while still have a cough. cut off by CDC
Healthcare visit (other): Drive through testing facility
Release 9 — 6 months, dose 2
Symptoms: Cough, fever, sore throat. Had a covid test . . It can back negative for covid 19 and varients.
Release 12 — 6 months, dose 4
Symptoms: Cold, cough, sore throat, congestion.
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 | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Impaired work ability | ✓ | ✓ | ✓ |
| SD | Influenza | ✓ | ✓ | ✓ |
| SD | Influenza virus test negative | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release