Z82-16255-46828
2 vaccinations
6 coded responses
15 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 737 / OK
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 1 — Janssen/Johnson & Johnson
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2021-03-17
Survey response — day 7, dose 1MedDRA: Injection site warmth — Feeling: GoodFree text: Heat at the injection site, about 2 inches in diameter.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-03-31
- 2021-09-08
-
2021-10-27
Dose 2 — Moderna
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2021-10-31
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-11-01
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain, Decreased appetite, Headache — Feeling: Poor · Site: Pain · Headache, Abdominal painFree text: This is no where close to accurate because Day 1 and 2 were debilitating and since then abdominal pain, headache and poor appetite have been the norm.MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Musculoskeletal discomfort, Self-medication — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painFree text: Moderna Vaccination shot 10-27-21 Day 1 10am Shot was administered around 10am. 4pm Started feeling shoulder and neck discomfort. 7pm Fever setting in around 100°F when checked. 7pm Started Tylenol and Ibuprofen rotation (no less than 4 hours) 4am WMedDRA releases: 2024-11 · check-in free text available
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2021-11-03
Health check-in — day 7, dose 2Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-11-11
- 2021-11-17
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2021-11-24
Survey response — day 28, dose 2MedDRA: Abdominal pain — Feeling: FairFree text: Mild Abdominal pain same as the week after the injection.MedDRA releases: 2024-11 · check-in free text available
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2021-12-01
Survey response — day 35, dose 2MedDRA: Abdominal pain — Feeling: FairFree text: Mild abdominal pain.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-08
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2022-01-28
Survey response — 3 months, dose 2MedDRA: Arthralgia, Headache, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sinusitis, headache shoulder painMedDRA releases: 2024-11 · check-in free text available
-
2022-01-28
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-03-24
Call successfulDoes not wish to fill out VAERS report
- 2022-04-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-28 | Successful 2022-03-24 |
Does not wish to fill out VAERS report |
Free text
Release 5 — day 7, dose 1
Systemic reaction (other): Heat at the injection site, about 2 inches in diameter.
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): This is no where close to accurate because Day 1 and 2 were debilitating and since then abdominal pain, headache and poor appetite have been the norm.
Systemic reaction (other): Moderna Vaccination shot 10-27-21 Day 1 10am Shot was administered around 10am. 4pm Started feeling shoulder and neck discomfort. 7pm Fever setting in around 100°F when checked. 7pm Started Tylenol and Ibuprofen rotation (no less than 4 hours) 4am W cut off by CDC
Release 10 — day 28, dose 2
Symptoms: Mild Abdominal pain same as the week after the injection.
Release 10 — day 35, dose 2
Symptoms: Mild abdominal pain.
Release 11 — 3 months, dose 2
Symptoms: Sinusitis, headache shoulder 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 |
|---|---|---|---|---|
| SD | Abdominal pain | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Abdominal pain | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal discomfort | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release