2YH-38613-94212
3 vaccinations
5 coded responses
15 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 16-20
- ZIP prefix
- 142 / NY
- Registered
- 2021-04-25
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-12
Dose 1 — Moderna
-
2021-04-25
Registered in v-safe
-
2021-04-26
Survey response — day 14, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: I never had a check in before but my arm hurt a bit for a couple days after the shot. Nothing serious in the slightest bit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
-
2021-05-10
Dose 2 — Moderna
-
2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: GoodFree text: I had a bad headache and couldn't work the day after the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-27
-
2021-05-31
Survey response — day 21, dose 2MedDRA: Feeling abnormal — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Actually its been since my last check in but I didn't hink it was vaccine related. Really bad bowel movements. Feels bad.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-09
Survey response — day 28, dose 2MedDRA: Abdominal pain upper, Cough, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Stomach pain, threw up, coughing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-16
- 2021-06-21
- 2021-08-09
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2021-11-08
Survey response — 6 months, dose 2MedDRA: Infection, SARS-CoV-2 test negative — Feeling: Good · 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, Outpatient clinic or urgent care clinic visitFree text: I got an unknown infection which, according to rapid testing, was not COVID-19 but did seem to respond to antibiotics.MedDRA releases: 2024-11 · check-in free text available
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2021-11-08
Report sent to call center — 6 months, dose 2Be 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-10
Call successfulParticipant prefers to complete VAERS report online
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2021-12-22
Dose 3 — Pfizer-BioNTech
- 2022-12-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Moderna | |
| 2 | 2021-05-10 | Moderna | |
| 3 | 2021-12-22 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 8 — day 14, dose 1
Symptoms: I never had a check in before but my arm hurt a bit for a couple days after the shot. Nothing serious in the slightest bit.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I had a bad headache and couldn't work the day after the shot.
Release 8 — day 21, dose 2
Symptoms: Actually its been since my last check in but I didn't hink it was vaccine related. Really bad bowel movements. Feels bad.
Release 9 — day 28, dose 2
Symptoms: Stomach pain, threw up, coughing.
Release 10 — 6 months, dose 2
Symptoms: I got an unknown infection which, according to rapid testing, was not COVID-19 but did seem to respond to antibiotics.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Infection | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release