ZY9-26142-35808
5 vaccinations
5 coded responses
40 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 070 / NJ
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
-
2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: Good · Site: PainFree text: Its not clear if the previous question is just with regard to past pain or current. No current pain. Pain ended I believe 3 days post vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-05
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
- 2021-09-01
-
2021-09-10
Dose 3 — Moderna
- 2021-10-28
-
2021-12-10
Survey response — 3 months, dose 3MedDRA: Lipoma excision — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Developed lipoma approximately 2-2.5cm in diameter behind shoulder (vaccines were in left arm, sorry, I can't remember if booster was R or L and card doesn't say). Had it removed. Benign biopsy result.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-11
Survey response — 6 months, dose 3MedDRA: Arthralgia, Pain in extremity — Feeling: GoodFree text: Pain in right shoulder, right thumb (arthritis?)MedDRA releases: 2024-11 · check-in free text available
-
2022-04-01
Dose 4 — Moderna
- 2022-04-14
- 2022-04-15
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-07-01
-
2022-09-16
Dose 5 — Moderna
- 2022-09-30
- 2022-10-14
- 2022-10-21
-
2022-10-28
Survey response — day 42, dose 5MedDRA: Gastrointestinal disorder — Feeling: GoodFree text: Intestinal issuesMedDRA releases: 2024-11 · check-in free text available
- 2022-12-16
-
2023-03-17
Survey response — 6 months, dose 5MedDRA: Arthritis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-03-17
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)
-
2023-03-20
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-09-10 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-09-16 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Its not clear if the previous question is just with regard to past pain or current. No current pain. Pain ended I believe 3 days post vaccine.
Release 10 — 3 months, dose 3
Symptoms: Developed lipoma approximately 2-2.5cm in diameter behind shoulder (vaccines were in left arm, sorry, I can't remember if booster was R or L and card doesn't say). Had it removed. Benign biopsy result.
Release 11 — 6 months, dose 3
Symptoms: Pain in right shoulder, right thumb (arthritis?)
Release 12 — day 42, dose 5
Symptoms: Intestinal issues
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 | Arthritis | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Lipoma excision | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release