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ZXA-30376-81007

2 vaccinations 5 coded responses 24 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
077 / NJ
Registered
2021-01-31
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-30
    Dose 1 — Moderna
  2. 2021-01-31
    Registered in v-safe
  3. 2021-02-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypotension, Loss of consciousness — Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: I passed out lowered Blood Pressure this was All on 1/30 day after shot missed the email
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Good · Joint pains
    Free text: None only next day after vaccine then normal
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-08
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-21
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-27
    Dose 2 — Moderna
  12. 2021-02-27
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  13. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  14. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fever · Chills, Joint pains · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-03-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Decreased appetite — Feeling: Fair · Fatigue or tiredness, Nausea
    Free text: No appetite
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-06
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-15
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-20
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-03
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-10
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-29
    Survey response — 3 months, dose 2
    MedDRA: Ageusia, Anosmia, Brain fog, Condition aggravated, Fatigue, Pre-existing disease — Feeling: Good
    Free text: Brain fog, memory worse taste still no totally normal, smell not totally back to normal. Fatigue, ambition fair. This from having COVID not
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-08-28
    Survey response — 6 months, dose 2
    MedDRA: Amnesia, Apathy, Balance disorder, Fatigue, Hyposmia, Pre-existing disease, Taste disorder — Feeling: Good
    Free text: Fatigue, still have taste not like use to be, balance off, smell is not returned all the way, lack of memory issues, lack of ambition. I did have COVID before vaccine
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  27. 2022-02-27
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-30Moderna
22021-02-27Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): I passed out lowered Blood Pressure this was All on 1/30 day after shot missed the email

2021-02-02

Systemic reaction (other): None only next day after vaccine then normal

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): No appetite

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Brain fog, memory worse taste still no totally normal, smell not totally back to normal. Fatigue, ambition fair. This from having COVID not

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Fatigue, still have taste not like use to be, balance off, smell is not returned all the way, lack of memory issues, lack of ambition. I did have COVID before vaccine

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
SDAgeusia ✓ ✓ ✓
SDAmnesia ✓ · ✓
SDAnosmia ✓ ✓ ✓
SDApathy ✓ · ✓
SDBalance disorder ✓ · ✓
SDBrain fog ✓ ✓ ✓
SDCondition aggravated ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHyposmia ✓ · ✓
SDPre-existing disease ✓ ✓ ✓
SDTaste disorder ✓ · ✓
SROAdverse reaction ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SROHypotension ✓ ✓ ✓
SROLoss of consciousness ✓ ✓ ✓

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