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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

  1. 2021-03-10
    Registered in v-safe
  2. 2021-03-10
    Dose 1 — Janssen/Johnson & Johnson
  3. 2021-03-17
    Survey response — day 7, dose 1
    MedDRA: Injection site warmth — Feeling: Good
    Free text: Heat at the injection site, about 2 inches in diameter.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-26
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-03-31
    Health check-in — day 21, single dose
    Feeling: Good
    Adult check-in
  6. 2021-09-08
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-10-27
    Dose 2 — Moderna
  8. 2021-10-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: 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 activities
    Adult check-in
  9. 2021-11-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Abdominal pain, Decreased appetite, Headache — Feeling: Poor · Site: Pain · Headache, Abdominal pain
    Free 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
  10. 2021-11-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Body temperature increased, Musculoskeletal discomfort, Self-medication — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Free 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 W
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-11-03
    Health check-in — day 7, dose 2
    Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain
    Adult check-in
  12. 2021-11-11
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-11-17
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  14. 2021-11-24
    Survey response — day 28, dose 2
    MedDRA: Abdominal pain — Feeling: Fair
    Free text: Mild Abdominal pain same as the week after the injection.
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-12-01
    Survey response — day 35, dose 2
    MedDRA: Abdominal pain — Feeling: Fair
    Free text: Mild abdominal pain.
    MedDRA releases: 2024-11 · check-in free text available
  16. 2021-12-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  17. 2022-01-28
    Survey response — 3 months, dose 2
    MedDRA: Arthralgia, Headache, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Sinusitis, headache shoulder pain
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-01-28
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  19. 2022-03-24
    Call successful
    Does not wish to fill out VAERS report
  20. 2022-04-27
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-10Janssen/Johnson & Johnson
22021-10-27Moderna No

Call center

ReportedOutcomeVAERS-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

2021-03-17

Systemic reaction (other): Heat at the injection site, about 2 inches in diameter.

Release 10 — days 1–6 daily, dose 2

2021-11-01

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.

2021-11-02

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

2021-11-24

Symptoms: Mild Abdominal pain same as the week after the injection.

Release 10 — day 35, dose 2

2021-12-01

Symptoms: Mild abdominal pain.

Release 11 — 3 months, dose 2

2022-01-28

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain · · ✓
SDArthralgia · · ✓
SDHeadache · · ✓
SDSinusitis · · ✓
SROAbdominal pain · · ✓
SROBody temperature increased · · ✓
SRODecreased appetite · · ✓
SROHeadache · · ✓
SROInjection site warmth ✓ ✓ ✓
SROMusculoskeletal discomfort · · ✓
SROSelf-medication · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release