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
-
2021-01-30
Dose 1 — Moderna
-
2021-01-31
Registered in v-safe
-
2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Hypotension, Loss of consciousness — Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: I passed out lowered Blood Pressure this was All on 1/30 day after shot missed the emailMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · Joint painsFree text: None only next day after vaccine then normalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-08
- 2021-02-13
- 2021-02-21
-
2021-02-27
Dose 2 — Moderna
- 2021-02-27
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Joint pains · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite — Feeling: Fair · Fatigue or tiredness, NauseaFree text: No appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-15
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
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2021-05-29
Survey response — 3 months, dose 2MedDRA: Ageusia, Anosmia, Brain fog, Condition aggravated, Fatigue, Pre-existing disease — Feeling: GoodFree text: Brain fog, memory worse taste still no totally normal, smell not totally back to normal. Fatigue, ambition fair. This from having COVID notMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-28
Survey response — 6 months, dose 2MedDRA: Amnesia, Apathy, Balance disorder, Fatigue, Hyposmia, Pre-existing disease, Taste disorder — Feeling: GoodFree 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 vaccineMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2022-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I passed out lowered Blood Pressure this was All on 1/30 day after shot missed the email
Systemic reaction (other): None only next day after vaccine then normal
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): No appetite
Release 8 — 3 months, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Ageusia | ✓ | ✓ | ✓ |
| SD | Amnesia | ✓ | · | ✓ |
| SD | Anosmia | ✓ | ✓ | ✓ |
| SD | Apathy | ✓ | · | ✓ |
| SD | Balance disorder | ✓ | · | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hyposmia | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Taste disorder | ✓ | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Hypotension | ✓ | ✓ | ✓ |
| SRO | Loss of consciousness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release