Y2V-10258-46222
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 114 / NY
- Registered
- 2021-05-12
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-01
Dose 1 — Moderna
-
2021-05-12
Registered in v-safe
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2021-05-12
Survey response — day 7, dose 1MedDRA: Decreased appetite — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Loss of Appetite - I experienced all these symptoms the next day after receiving my 1st Moderna shot on Sunday, May 2, 2021.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-05-22
-
2021-05-29
Dose 2 — Moderna
-
2021-05-29
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Joint pains, Muscle or body achesAdult check-in
-
2021-06-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
-
2021-06-02
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesFree text: Slight Chest Pain on the Left SideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Joint pains, Muscle or body achesAdult check-in
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2021-06-04
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain, Office visit — Feeling: Fair · Muscle or body aches · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I've been having chest pain on my left side after receiving my 2nd Moderna vaccination shot on May 29th. · Healthcare visit (other): In person visit to my Cardiologist on June 3rd and had an electrocardiogram test and blood drawn for testing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-04
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-05
Survey response — day 7, dose 2MedDRA: Chest pain — Feeling: Fair · Muscle or body achesFree text: Still experiencing slight chest pain on my left side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-12
- 2021-06-19
- 2021-06-26
- 2021-07-03
- 2021-07-10
- 2021-08-28
-
2022-01-28
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-01 | Moderna | |
| 2 | 2021-05-29 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-04 | Successful 2022-01-28 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — day 7, dose 1
Systemic reaction (other): Loss of Appetite - I experienced all these symptoms the next day after receiving my 1st Moderna shot on Sunday, May 2, 2021.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Slight Chest Pain on the Left Side
Systemic reaction (other): I've been having chest pain on my left side after receiving my 2nd Moderna vaccination shot on May 29th.
Healthcare visit (other): In person visit to my Cardiologist on June 3rd and had an electrocardiogram test and blood drawn for testing.
Release 8 — day 7, dose 2
Systemic reaction (other): Still experiencing slight chest pain on my left side.
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 | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release