ZJC-32296-87842
5 vaccinations
14 coded responses
64 check-ins
13 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 168 / PA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-13
Registered in v-safe
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2021-04-13
Dose 1 — Moderna
- 2021-04-13
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2021-04-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
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2021-04-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body achesAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-22
- 2021-04-27
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2021-05-04
Survey response — day 21, dose 1MedDRA: Confusional state, Fatigue, Memory impairment — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: May not be related to the shot as I started statins a couple days ago. Tiredness, memory challenges and some confusionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-11
Dose 2 — Moderna
- 2021-05-11
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2021-05-12
Survey response — days 1–6 daily, dose 2MedDRA: Pain in jaw — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Pain in jaw joint same side as shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-15
- 2021-05-16
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2021-05-18
Survey response — day 7, dose 2MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tirednessFree text: Could be allergy related tree pollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-25
- 2021-06-01
- 2021-06-10
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2021-06-15
Survey response — day 35, dose 2MedDRA: Fatigue, Headache — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fatigue and headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-22
- 2021-08-10
- 2021-11-09
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2021-12-07
Dose 3 — Moderna
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2021-12-08
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-12-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
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2022-01-18
Survey response — day 42, dose 3MedDRA: Diarrhoea — Feeling: FairFree text: DiarrheaMedDRA releases: 2024-11 · check-in free text available
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2022-03-08
Survey response — 3 months, dose 3MedDRA: Fatigue, Office visit, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Fatigue, brain functions, digestive all periodically · Healthcare visit (other): Dr office visitMedDRA releases: 2024-11 · check-in free text available
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2022-03-08
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-03-10
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2022-06-07
Survey response — 6 months, dose 3MedDRA: Fatigue, Headache, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Believe allergies. Headache sinus tiredMedDRA releases: 2024-11 · check-in free text available
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2022-07-19
Dose 4 — Moderna
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2022-07-20
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-07-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-07-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
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2022-07-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
- 2022-07-24
- 2022-07-25
- 2022-07-26
- 2022-08-03
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2022-08-09
Survey response — day 21, dose 4MedDRA: Lung disorder, Office visit, SARS-CoV-2 test negative — Feeling: FairFree text: Some sense of lung changes Saw doctor but tested negative for CovidMedDRA releases: 2024-11 · check-in free text available
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2022-08-16
Survey response — day 28, dose 4MedDRA: Respiratory disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sensation of some issues with breathing. However spirometer and EKG are goodMedDRA releases: 2024-11 · check-in free text available
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2022-08-16
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-08-17
- 2022-08-17
- 2022-08-23
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2022-10-18
Survey response — 3 months, dose 4MedDRA: Fatigue, Headache, Pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fatigue Headache other body achesMedDRA releases: 2024-11 · check-in free text available
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2022-11-07
Dose 5 — Moderna
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2022-11-08
Survey response — days 1–6 daily, dose 5MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Respiratory but oximeter says 98%MedDRA releases: 2024-11 · check-in free text available
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2022-11-09
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-11-10
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
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2022-11-11
Survey response — days 1–6 daily, dose 5MedDRA: Sinus congestion — Feeling: Fair · Headache, Fatigue or tirednessFree text: Sinus congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-11-12
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2022-11-13
Survey response — days 1–6 daily, dose 5MedDRA: Respiratory tract irritation — Feeling: FairFree text: Some minor respiratory irritationMedDRA releases: 2024-11 · check-in free text available
- 2022-11-14
- 2022-11-21
- 2022-11-28
- 2022-12-05
- 2022-12-12
- 2022-12-19
- 2023-02-08
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2023-05-08
Survey response — 6 months, dose 5MedDRA: Fatigue, Influenza virus test negative, Office visit, SARS-CoV-2 test negative, Total lung capacity decreased, Viral infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-05-08
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2023-05-09
- 2023-05-09
- 2023-05-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Moderna | |
| 2 | 2021-05-11 | Moderna | |
| 3 | 2021-12-07 | Moderna | No |
| 4 | 2022-07-19 | Moderna | No |
| 5 | 2022-11-07 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-08 | Unsuccessful | |
| 2022-08-16 | Unsuccessful | |
| 2023-05-08 | Unsuccessful |
Free text
Release 8 — day 21, dose 1
Symptoms: May not be related to the shot as I started statins a couple days ago. Tiredness, memory challenges and some confusion
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Pain in jaw joint same side as shot
Release 8 — day 7, dose 2
Systemic reaction (other): Could be allergy related tree pollen
Release 9 — day 35, dose 2
Symptoms: Fatigue and headaches
Release 10 — day 42, dose 3
Symptoms: Diarrhea
Release 11 — 3 months, dose 3
Symptoms: Fatigue, brain functions, digestive all periodically
Healthcare visit (other): Dr office visit
Release 11 — 6 months, dose 3
Symptoms: Believe allergies. Headache sinus tired
Release 12 — day 21, dose 4
Symptoms: Some sense of lung changes Saw doctor but tested negative for Covid
Release 12 — day 28, dose 4
Symptoms: Sensation of some issues with breathing. However spirometer and EKG are good
Release 12 — 3 months, dose 4
Symptoms: Fatigue Headache other body aches
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Respiratory but oximeter says 98%
Systemic reaction (other): Sinus congestion
Systemic reaction (other): Some minor respiratory irritation
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 | Confusional state | ✓ | ✓ | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Lung disorder | · | · | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Total lung capacity decreased | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Respiratory tract irritation | · | · | ✓ |
| SRO | Sinus congestion | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release