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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

  1. 2021-04-12
    Dose 1 — Moderna
  2. 2021-04-25
    Registered in v-safe
  3. 2021-04-26
    Survey response — day 14, dose 1
    MedDRA: Pain in extremity — Feeling: Good
    Free 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
  4. 2021-05-04
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-05-10
    Dose 2 — Moderna
  6. 2021-05-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache — Feeling: Good
    Free 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
  7. 2021-05-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-05-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-05-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-05-17
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-05-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-05-31
    Survey response — day 21, dose 2
    MedDRA: Feeling abnormal — Feeling: Poor · Be unable to do your normal daily activities
    Free 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
  13. 2021-06-09
    Survey response — day 28, dose 2
    MedDRA: Abdominal pain upper, Cough, Vomiting — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Stomach pain, threw up, coughing.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-06-16
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  15. 2021-06-21
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-08-09
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-11-08
    Survey response — 6 months, dose 2
    MedDRA: 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 visit
    Free 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
  18. 2021-11-08
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  19. 2021-11-10
    Call successful
    Participant prefers to complete VAERS report online
  20. 2021-12-22
    Dose 3 — Pfizer-BioNTech
  21. 2022-12-22
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-12Moderna
22021-05-10Moderna
32021-12-22Pfizer-BioNTech No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — day 14, dose 1

2021-04-26

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

2021-05-13

Systemic reaction (other): I had a bad headache and couldn't work the day after the shot.

Release 8 — day 21, dose 2

2021-05-31

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

2021-06-09

Symptoms: Stomach pain, threw up, coughing.

Release 10 — 6 months, dose 2

2021-11-08

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDInfection · · ✓
SDPain in extremity ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SDVomiting ✓ ✓ ✓
SROHeadache ✓ ✓ ✓

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