ZFE-94102-26367
1 vaccination
5 coded responses
11 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 074 / NJ
- Registered
- 2021-09-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-09-30
Registered in v-safe
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2021-09-30
Dose 1 — Moderna
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2021-09-30
Survey response — day 0, dose 1MedDRA: Mobility decreased — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Unable to lift my armMedDRA releases: 2024-11 · check-in free text available
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2021-10-01
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-02
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Nausea, Vomiting, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-06
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-07
Health check-in — day 7, dose 1Feeling: Fair · Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-14
Survey response — day 14, dose 1MedDRA: Gastrointestinal disorder — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Still dealing with stomach issues that I never had before. When will this end? I am so terrified of getting my second dose.MedDRA releases: 2024-11 · check-in free text available
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2021-10-21
Survey response — day 21, dose 1MedDRA: Back disorder, Gastrointestinal disorder, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Back stomach problems, constant pain & going to the bathroomMedDRA releases: 2024-11 · check-in free text available
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2022-04-02
Survey response — 6 months, dose 1MedDRA: Cardiac disorder, Office visit, Palpitations — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: I started having heart palpitations. · Healthcare visit (other): I had to see two different doctors for my heart issues that randomly started a few months after the vaccine. I've never had issues like this before.MedDRA releases: 2024-11 · check-in free text available
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2022-04-02
Report sent to call center — 6 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-04-05
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2022-09-30
Survey response — 12 months, dose 1MedDRA: Palpitations — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Heart palpitations that started shortly after vaccine are getting worseMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-02 | Unsuccessful |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): Unable to lift my arm
Release 10 — day 14, dose 1
Symptoms: Still dealing with stomach issues that I never had before. When will this end? I am so terrified of getting my second dose.
Release 10 — day 21, dose 1
Symptoms: Back stomach problems, constant pain & going to the bathroom
Release 11 — 6 months, dose 1
Symptoms: I started having heart palpitations.
Healthcare visit (other): I had to see two different doctors for my heart issues that randomly started a few months after the vaccine. I've never had issues like this before.
Release 12 — 12 months, dose 1
Symptoms: Heart palpitations that started shortly after vaccine are getting worse
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 | Cardiac disorder | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Back disorder | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SRO | Mobility decreased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release