Y9E-27862-33417
4 vaccinations
6 coded responses
41 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 086 / NJ
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Registered in v-safe
-
2021-02-02
Dose 1 — Moderna
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-17
- 2021-02-23
-
2021-03-02
Dose 2 — Moderna
-
2021-03-02
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: None. But shot was lass than an hour ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Hyperhidrosis, Insomnia — Feeling: Good · Site: PainFree text: Didnt sleep well. Was sweating a bit at some point in the night. Had some mildly aching joints (left hip? right ankle?), but those symptoms disappeared 1530 min. after I got up.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Dull ache in left hip. Goes away after Ive been up for 1530 min. Slightly sharper pain in right elbow. Probably neither is related to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: GoodFree text: Same ones mentioned yesterday, both of which probably unrelated to the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — day 7, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Same comment as in the last two days (mild joint aches that are probably unrelated to the vaccine).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
- 2021-03-31
- 2021-04-06
- 2021-04-13
- 2021-06-01
- 2021-08-31
-
2021-10-26
Dose 3 — Pfizer-BioNTech
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-09
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2022-01-28
Survey response — 3 months, dose 3MedDRA: Headache, Laboratory test abnormal, Oropharyngeal pain, Polymerase chain reaction positive, Pyrexia, Quarantine — Feeling: Good · Be unable to work or attend schoolFree text: Had slight fever, slight headache, & slight sore throat late 12/31/21 to midday 1/1/22. Then felt normal but tested positive on 1/5/22 PCR. Continued to feel normal, tested positive on rapid tests 1/10 & 1/11, & tested negative on 1/12. (Quarantined)MedDRA releases: 2024-11 · check-in free text available
- 2022-04-26
-
2022-04-29
Dose 4 — Moderna
- 2022-05-18
- 2022-05-30
- 2022-06-06
- 2022-07-30
- 2022-10-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-10-26 | Pfizer-BioNTech | No |
| 4 | 2022-04-29 | Moderna | No |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): None. But shot was lass than an hour ago.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Didnt sleep well. Was sweating a bit at some point in the night. Had some mildly aching joints (left hip? right ankle?), but those symptoms disappeared 1530 min. after I got up.
Systemic reaction (other): Dull ache in left hip. Goes away after Ive been up for 1530 min. Slightly sharper pain in right elbow. Probably neither is related to the vaccine.
Systemic reaction (other): Same ones mentioned yesterday, both of which probably unrelated to the vaccination.
Release 5 — day 7, dose 2
Systemic reaction (other): Same comment as in the last two days (mild joint aches that are probably unrelated to the vaccine).
Release 11 — 3 months, dose 3
Symptoms: Had slight fever, slight headache, & slight sore throat late 12/31/21 to midday 1/1/22. Then felt normal but tested positive on 1/5/22 PCR. Continued to feel normal, tested positive on rapid tests 1/10 & 1/11, & tested negative on 1/12. (Quarantined) cut off by CDC
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 | Headache | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Polymerase chain reaction positive | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Quarantine | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release