ZXG-19591-60684
5 vaccinations
10 coded responses
67 check-ins
9 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 088 / NJ
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-09
Registered in v-safe
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2021-02-09
Dose 1 — Moderna
- 2021-02-09
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2021-02-10
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
- 2021-03-02
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2021-03-09
Dose 2 — Moderna
- 2021-03-09
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2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-06-08
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2021-08-20
Dose 3 — Moderna
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2021-08-20
Survey response — day 0, dose 3MedDRA: Pre-existing disease — Feeling: Good · Site: PainFree text: I received my third shot because my spleen was removed.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-21
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-08-22
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-08-23
Survey response — days 1–6 daily, dose 3MedDRA: Arrhythmia, Palpitations — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, NauseaFree text: Palpitations and arrhythmiaMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-24
Survey response — days 1–6 daily, dose 3MedDRA: Heart rate irregular — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal painFree text: Heart Rhythm issue seems to be betterMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body achesAdult check-in
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2021-08-26
Survey response — days 1–6 daily, dose 3MedDRA: Arrhythmia, Cardiac flutter — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Heart flutter and arrhythmiasMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-27
Survey response — day 7, dose 3MedDRA: Heart rate irregular — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Irregular heartbeat getting better.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-03
- 2021-09-10
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2021-09-17
Survey response — day 28, dose 3MedDRA: Gastrointestinal disorder, Joint swelling, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Stomach issues in addition to swelling in my knees and hands.MedDRA releases: 2024-11 · check-in free text available
- 2021-09-24
- 2021-10-01
- 2021-11-19
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2022-02-18
Survey response — 6 months, dose 3MedDRA: Arthralgia, Pre-existing disease — Feeling: FairFree text: Reactive arthritis painMedDRA releases: 2024-11 · check-in free text available
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2022-04-05
Dose 4 — Moderna
- 2022-04-05
-
2022-04-06
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-07
- 2022-04-08
-
2022-04-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-04-10
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fever · Headache, Fatigue or tirednessAdult check-in
-
2022-04-11
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-12
- 2022-04-19
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2022-04-26
Survey response — day 21, dose 4MedDRA: Fatigue, Leukocytosis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Just general fatigue and unexplained leucocytosis. Consultation with hematologist. · Healthcare visit (other): SpecialistMedDRA releases: 2024-11 · check-in free text available
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2022-04-26
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-27
- 2022-05-03
- 2022-05-11
- 2022-05-17
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2022-05-17
Call successfulDoes not wish to fill out VAERS report
- 2022-07-07
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2022-09-16
Dose 5 — Moderna
- 2022-09-16
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2022-09-17
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body achesAdult check-in
-
2022-09-18
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-19
- 2022-09-20
-
2022-09-21
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Joint pains, Muscle or body achesAdult check-in
-
2022-09-22
Health check-in — days 1–6 daily, dose 5Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2022-09-23
- 2022-09-30
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2022-10-07
Survey response — day 21, dose 5MedDRA: Headache, Musculoskeletal stiffness, Pyrexia — Feeling: FairFree text: Have a low grade fever and headache today with a stiff neckMedDRA releases: 2024-11 · check-in free text available
- 2022-10-16
- 2022-10-21
- 2022-10-28
- 2022-12-16
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2023-03-19
Survey response — 6 months, dose 5MedDRA: Feeling abnormal, Hospitalisation, Pre-existing disease — 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 consultation, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
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2023-03-19
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 prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
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2023-03-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-09 | Moderna | |
| 3 | 2021-08-20 | Moderna | No |
| 4 | 2022-04-05 | Moderna | No |
| 5 | 2022-09-16 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 9 — day 0, dose 3
Systemic reaction (other): I received my third shot because my spleen was removed.
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Palpitations and arrhythmia
Systemic reaction (other): Heart Rhythm issue seems to be better
Systemic reaction (other): Heart flutter and arrhythmias
Release 9 — day 7, dose 3
Systemic reaction (other): Irregular heartbeat getting better.
Release 9 — day 28, dose 3
Symptoms: Stomach issues in addition to swelling in my knees and hands.
Release 11 — 6 months, dose 3
Symptoms: Reactive arthritis pain
Release 11 — day 21, dose 4
Symptoms: Just general fatigue and unexplained leucocytosis. Consultation with hematologist.
Healthcare visit (other): Specialist
Release 12 — day 21, dose 5
Symptoms: Have a low grade fever and headache today with a stiff neck
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 | Arthralgia | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Joint swelling | · | · | ✓ |
| SD | Leukocytosis | · | · | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Arrhythmia | ✓ | · | ✓ |
| SRO | Cardiac flutter | ✓ | · | ✓ |
| SRO | Heart rate irregular | ✓ | · | ✓ |
| SRO | Palpitations | ✓ | · | ✓ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release