ZPD-12099-64028
5 vaccinations
19 coded responses
60 check-ins
18 free-text entries
7 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 080 / NJ
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Registered in v-safe
-
2020-12-29
Dose 1 — Moderna
- 2020-12-29
-
2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-14
- 2021-01-20
-
2021-01-26
Dose 2 — Moderna
- 2021-01-26
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
- 2021-07-27
-
2021-10-30
Dose 3 — Moderna
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: Swollen lymph nodesMedDRA releases: 2024-11 · check-in free text available
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Supraclavicular lymph node is enlarged left side onlyMedDRA releases: 2024-11 · check-in free text available
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · HeadacheFree text: Supraclavicular lymph node is enlargedMedDRA releases: 2024-11 · check-in free text available
-
2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · HeadacheFree text: Swollen supraclavicular lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · HeadacheFree text: Enlarged supraclavicular lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — day 7, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · HeadacheFree text: Swollen lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Survey response — day 14, dose 3MedDRA: Fatigue, Lymphadenopathy — Feeling: FairFree text: Swollen supraclavicular lymph node and exhaustionMedDRA releases: 2024-11 · check-in free text available
- 2021-11-20
- 2021-11-27
- 2021-12-04
-
2021-12-11
Survey response — day 42, dose 3MedDRA: Osteoarthritis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Hip osteoarthritisMedDRA releases: 2024-11 · check-in free text available
-
2021-12-11
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-16
- 2021-12-21
-
2021-12-21
Call successfulParticipant prefers to complete VAERS report online
- 2022-01-29
-
2022-04-29
Dose 4 — Moderna
- 2022-04-30
-
2022-04-30
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-05-01
-
2022-05-02
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: Good · Site: PainFree text: Swollen midclavicular lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2022-05-03
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Enlarged midclavicular lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2022-05-04
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Swollen midclavicular lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2022-05-05
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Swollen lymph nodeMedDRA releases: 2024-11 · check-in free text available
-
2022-05-06
Survey response — day 7, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Swollen lymph nodeMedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-07-29
-
2022-09-20
Dose 5 — ModernaCo-administered: Flu
-
2022-10-10
Survey response — day 14, dose 5MedDRA: Mixed connective tissue disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Diagnosed with MCTDMedDRA releases: 2024-11 · check-in free text available
-
2022-10-10
Report sent to call center — day 14, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-11
Survey response — day 21, dose 5MedDRA: Mixed connective tissue disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Mixed Connective Tissue DiseaseMedDRA releases: 2024-11 · check-in free text available
-
2022-10-11
Report sent to call center — day 21, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-11
-
2022-10-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-18
Survey response — day 28, dose 5MedDRA: Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Mixed connective tissues diseaseMedDRA releases: 2024-11 · check-in free text available
-
2022-10-18
Report sent to call center — day 28, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-19
- 2022-10-24
-
2022-10-25
Survey response — day 35, dose 5MedDRA: Mixed connective tissue disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Rx with mixed connective disease on 10/7/22MedDRA releases: 2024-11 · check-in free text available
-
2022-10-25
Report sent to call center — day 35, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-26
-
2022-11-01
Survey response — day 42, dose 5MedDRA: Mixed connective tissue disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: MCTDMedDRA releases: 2024-11 · check-in free text available
-
2022-11-01
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-02
- 2022-11-02
- 2022-11-02
- 2022-12-20
-
2023-03-21
Survey response — 6 months, dose 5MedDRA: Mixed connective tissue disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-03-21
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-03-22
- 2023-03-22
- 2023-03-22
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-26 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
| 4 | 2022-04-29 | Moderna | No |
| 5 | 2022-09-20 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-11 | Successful 2021-12-21 |
Participant prefers to complete VAERS report online |
| 2022-10-10 | Successful 2022-10-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-11 | Successful 2022-10-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-18 | Unsuccessful | |
| 2022-10-25 | Unsuccessful | |
| 2022-11-01 | Unsuccessful | |
| 2023-03-21 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swollen lymph nodes
Systemic reaction (other): Supraclavicular lymph node is enlarged left side only
Systemic reaction (other): Supraclavicular lymph node is enlarged
Systemic reaction (other): Swollen supraclavicular lymph node
Systemic reaction (other): Enlarged supraclavicular lymph node
Release 10 — day 7, dose 3
Systemic reaction (other): Swollen lymph node
Release 10 — day 14, dose 3
Symptoms: Swollen supraclavicular lymph node and exhaustion
Release 10 — day 42, dose 3
Symptoms: Hip osteoarthritis
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Swollen midclavicular lymph node
Systemic reaction (other): Enlarged midclavicular lymph node
Systemic reaction (other): Swollen midclavicular lymph node
Systemic reaction (other): Swollen lymph node
Release 11 — day 7, dose 4
Systemic reaction (other): Swollen lymph node
Release 12 — day 14, dose 5
Symptoms: Diagnosed with MCTD
Release 12 — day 21, dose 5
Symptoms: Mixed Connective Tissue Disease
Release 12 — day 28, dose 5
Symptoms: Mixed connective tissues disease
Release 12 — day 35, dose 5
Symptoms: Rx with mixed connective disease on 10/7/22
Release 12 — day 42, dose 5
Symptoms: MCTD
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 | Fatigue | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Mixed connective tissue disease | · | · | ✓ |
| SD | Osteoarthritis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release