Y4L-39985-94348
4 vaccinations
3 coded responses
35 check-ins
3 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 787 / TX
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-31
Registered in v-safe
-
2020-12-31
Dose 1 — Moderna
-
2020-12-31
Health check-in — day 0, dose 1Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2020-12-31
Report sent to call center — day 0, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
-
2021-01-07
Survey response — day 7, dose 1MedDRA: Headache, Pre-existing disease — Feeling: Good · HeadacheFree text: I did have a headache at about 3 am today but think it is unrelated to the vaccine as it is exactly the type and severity I have been experiencing roughly once every three or so weeks for the past several months.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-14
- 2021-01-21
- 2021-01-28
-
2021-01-29
Dose 2 — Moderna
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-07
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-04-30
- 2021-07-30
-
2021-10-25
Dose 3 — Moderna
-
2022-01-29
Survey response — 12 months, dose 2MedDRA: COVID-19, Home care, Medical counselling — 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 consultationFree text: Symptoms: Covid · Healthcare visit (other): Home health nurse administered monoclonal antibody treatment.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-29
Report sent to call center — 12 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 · 1 call case(s)
-
2022-01-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-18
Dose 4 — Moderna
- 2022-04-26
- 2022-05-02
- 2022-05-10
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-07-18
-
2022-10-17
Survey response — 6 months, dose 4MedDRA: Emergency care, Hypnic headache, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Hypnic headache on Oct 13, 2022. Woke up to a severe headache at 0415 hrs and blood pressure was recorded then at 171/91. Treated at emergency room and all tests normal; BP medications adjusted and are being monitored. · Healthcare visit (other): See aboveMedDRA releases: 2024-11 · check-in free text available
-
2022-10-17
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna | |
| 2 | 2021-01-29 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2020-12-31 | priority 2/3 | |
| 2022-01-29 | Successful 2022-01-31 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-10-17 | Successful 2022-10-18 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): I did have a headache at about 3 am today but think it is unrelated to the vaccine as it is exactly the type and severity I have been experiencing roughly once every three or so weeks for the past several months.
Release 11 — 12 months, dose 2
Symptoms: Covid
Healthcare visit (other): Home health nurse administered monoclonal antibody treatment.
Release 12 — 6 months, dose 4
Symptoms: Hypnic headache on Oct 13, 2022. Woke up to a severe headache at 0415 hrs and blood pressure was recorded then at 171/91. Treated at emergency room and all tests normal; BP medications adjusted and are being monitored.
Healthcare visit (other): See above
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 | Home care | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Hypnic headache | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release