XYP-11012-53951
2 vaccinations
3 coded responses
22 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 840 / UT
- Registered
- 2021-01-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-03
Registered in v-safe
-
2021-01-03
Dose 1 — Moderna
- 2021-01-03
-
2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Chills, Injection site pain, Myalgia, Sleep disorder — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-05
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-17
- 2021-01-24
- 2021-01-31
-
2021-02-03
Dose 2 — Moderna
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Pain, Pyrexia — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-05-05
- 2021-08-04
-
2022-02-03
Survey response — 12 month, dose 2MedDRA: Respiratory tract congestion — Feeling: Fair · Be unable to work or attend schoolMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-03 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-05 | priority 2/3 |
Free text
Release 1
Systemic reaction (other): My symptoms were much worse yesterday. The check in link expired before I was able to use it. I would rate my symptoms as severe yesterday with significant site pain and muscle/joint pain. I got verry little if any sleep last night. I had chills most of the day yesterday and night but no associated fever.
Release 3
Systemic reaction (other): On Feb 4th the day after the 2nd shot I felt feverish and had moderate to severe body achse and injection site pain lasting 6-8 hours.
Release 11
Symptoms: Head and chest congestion
Free-text releases are not linked to a specific 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 | Respiratory tract congestion | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release