ZJ4-22950-43385
5 vaccinations
7 coded responses
43 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 588 / ND
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-27
Dose 1 — Moderna
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2021-04-05
Registered in v-safe
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2021-04-05
Survey response — day 7, dose 1MedDRA: Abdominal pain, Rash — Feeling: Good · Site: Redness, Swelling, Itching · Abdominal pain, Rash, not including the immediate area around the injection siteFree text: I had an abdominal pain two days ago, it was severe, and I still have weak abdominal pain right now. It is make sense that the rash came out after abdominal pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-17
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2021-04-24
Dose 2 — Moderna
- 2021-04-24
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2021-04-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body achesAdult check-in
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2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: I almost take a NYQUIL because of side effects, but I didn't. I thought my body adjust with vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Self-medication — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body achesFree text: Thid is not today but I had 101.32 °F when I went to bed ladt night. I took two motrins and temperature was down in two hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint painsAdult check-in
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2021-04-29
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint painsFree text: I forgot mention about my redness on injection site expandingto inside arm day by day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-30
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-10-23
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2021-11-02
Dose 3 — Moderna
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2021-11-02
Survey response — day 0, dose 3MedDRA: Injection site warmth, Mobility decreased — Feeling: Fair · Site: PainFree text: I can't put arm up over the shoulder and localized warmth at shot areaMedDRA releases: 2024-11 · check-in free text available
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2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site papule — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: I have red papule at injection site.MedDRA releases: 2024-11 · check-in free text available
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2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Body temperature fluctuation, Self-medication — Feeling: Good · Site: Pain, Redness, SwellingFree text: I took NYQUIL when I go bed last night because had up and down of temps.MedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
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2022-04-28
Dose 4 — Moderna
- 2022-04-28
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2022-04-29
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-04-30
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Abdominal painAdult check-in
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2022-05-01
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling, Itching · HeadacheAdult check-in
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2022-05-02
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · ChillsAdult check-in
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-06-02
- 2022-06-09
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2022-09-15
Dose 5 — Pfizer-BioNTech
- 2023-04-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-27 | Moderna | |
| 2 | 2021-04-24 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-04-28 | Moderna | No |
| 5 | 2022-09-15 | Pfizer-BioNTech | No |
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): I had an abdominal pain two days ago, it was severe, and I still have weak abdominal pain right now. It is make sense that the rash came out after abdominal pain.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I almost take a NYQUIL because of side effects, but I didn't. I thought my body adjust with vaccine.
Systemic reaction (other): Thid is not today but I had 101.32 °F when I went to bed ladt night. I took two motrins and temperature was down in two hours.
Systemic reaction (other): I forgot mention about my redness on injection site expandingto inside arm day by day.
Release 10 — day 0, dose 3
Systemic reaction (other): I can't put arm up over the shoulder and localized warmth at shot area
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have red papule at injection site.
Systemic reaction (other): I took NYQUIL when I go bed last night because had up and down of temps.
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 |
|---|---|---|---|---|
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Body temperature fluctuation | · | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site papule | · | · | ✓ |
| SRO | Injection site warmth | · | · | ✓ |
| SRO | Mobility decreased | · | · | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release