Z6J-33497-29869
2 vaccinations
5 coded responses
12 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 112 / NY
- Registered
- 2021-07-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-06-30
Dose 1 — Moderna
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2021-07-05
Registered in v-safe
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2021-07-05
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal chest pain — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Severe pain at the rib cage on a site of vaccinationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-06
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal chest pain, Painful respiration, Pyrexia — Feeling: Fair · Site: Pain · Fever · Muscle or body aches · Be unable to do your normal daily activitiesFree text: I had 102-103 fever for 6 days plus severe stabbing pain in a rib cage for 5 days. Today is day 7 and my temp is 37.5 and pain is rub cage is subsided so I can inhale. It was a pain on each inhalation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-07
Survey response — day 7, dose 1MedDRA: Pain — Feeling: Good · Fever · Be unable to do your normal daily activitiesFree text: Today is day 8 since I was vaccinated on june30 with a first dose. Today is the first day my pain is subsided but I still have 37.5 temperature.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-16
Survey response — day 14, dose 1MedDRA: Cough, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I developed cough. As a result of COVID vaccine. · Healthcare visit (other): Went to pulmonologistMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-16
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-21
- 2021-07-24
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2021-07-28
Dose 2 — Moderna
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2021-07-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-07-30
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: LightheadedMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fever · None · Be unable to do your normal daily activitiesAdult check-in
- 2021-08-01
- 2021-08-02
- 2021-08-04
- 2021-08-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-30 | Moderna | No |
| 2 | 2021-07-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-16 | Unsuccessful |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Severe pain at the rib cage on a site of vaccination
Systemic reaction (other): I had 102-103 fever for 6 days plus severe stabbing pain in a rib cage for 5 days. Today is day 7 and my temp is 37.5 and pain is rub cage is subsided so I can inhale. It was a pain on each inhalation.
Release 9 — day 7, dose 1
Systemic reaction (other): Today is day 8 since I was vaccinated on june30 with a first dose. Today is the first day my pain is subsided but I still have 37.5 temperature.
Release 9 — day 14, dose 1
Symptoms: I developed cough. As a result of COVID vaccine.
Healthcare visit (other): Went to pulmonologist
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Lightheaded
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 | Office visit | ✓ | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SRO | Dizziness | ✓ | · | ✓ |
| SRO | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Painful respiration | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release