Y3L-25443-14279
2 vaccinations
3 coded responses
15 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 339 / FL
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-01-15
Registered in v-safe
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-19
- 2021-01-21
-
2021-01-28
Survey response — day 14, dose 1MedDRA: Nausea — Feeling: FairFree text: Nausea this afternoon. Nothing til this episodeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
-
2021-02-09
Dose 2 — Moderna
-
2021-02-18
Survey response — day 7, dose 2MedDRA: Aphasia, Chills, Emergency care, Hospitalisation, Memory impairment, Tremor — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, HospitalizationFree text: Ten hours after the shot I had severe chills and shakes. About 23 hours after the shot I experienced partial loss of speech function and memory impairment. Was taken to the ER. While waiting six hours for a room symptoms dissipated. Was kept in hospital through the 12th of February. EEG, EKG and MRI revealed no causes, and no link or disassociation with the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Report sent to call center — day 7, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-08-09
- 2021-08-12
-
2022-02-09
Survey response — 12 months, dose 2MedDRA: Sleep apnoea syndrome, Transient ischaemic attack — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Have been diagnosed with sleep apnea and told to use a c pap. All this still related to the ministroke I suffered the day after vaccine number two in feb 2021MedDRA releases: 2024-11 · check-in free text available
-
2022-02-09
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-18 | Unsuccessful | |
| 2022-02-09 | Unsuccessful |
Free text
Release 2 — day 14, dose 1
Symptoms: Nausea this afternoon. Nothing til this episode
Release 4 — day 7, dose 2
Systemic reaction (other): Ten hours after the shot I had severe chills and shakes. About 23 hours after the shot I experienced partial loss of speech function and memory impairment. Was taken to the ER. While waiting six hours for a room symptoms dissipated. Was kept in hospital through the 12th of February. EEG, EKG and MRI revealed no causes, and no link or disassociation with the vaccine.
Release 11 — 12 months, dose 2
Symptoms: Have been diagnosed with sleep apnea and told to use a c pap. All this still related to the ministroke I suffered the day after vaccine number two in feb 2021
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 | Nausea | ✓ | ✓ | ✓ |
| SD | Sleep apnoea syndrome | · | · | ✓ |
| SD | Transient ischaemic attack | · | · | ✓ |
| SRO | Aphasia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Hospitalisation | ✓ | ✓ | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release