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Y5M-72450-91680

4 vaccinations 7 coded responses 41 check-ins 7 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
023 / MA
Registered
2021-01-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-22
    Registered in v-safe
  2. 2021-01-22
    Dose 1 — Moderna
  3. 2021-01-22
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-29
    Health check-in — day 7, dose 1
    Feeling: Good · Headache
    Adult check-in
  11. 2021-02-05
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-12
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-19
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-24
    Dose 2 — Moderna
  15. 2021-02-24
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  17. 2021-02-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness
    Free text: Runny nose
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains
    Adult check-in
  20. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains
    Adult check-in
  21. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  22. 2021-03-03
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  23. 2021-03-10
    Survey response — day 14, dose 2
    MedDRA: Erythema, Feeling hot — Feeling: Good
    Free text: My face gets red and I get hot. I do not have a fever.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-03-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-03-31
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-04-07
    Survey response — day 42, dose 2
    MedDRA: Chest pain, Cough — Feeling: Fair
    Free text: A lot of coughing on Monday. May have been due to pollen. Had some mild pain in my chest yesterday, last night and now. No idea what that is.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  28. 2021-05-26
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-08-25
    Survey response — 6 months, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Breathing problems that I attribute to the humidity. I have had these symptoms for use in high humidity.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  30. 2021-11-11
    Dose 3 — Moderna
  31. 2022-02-24
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in
  32. 2022-05-04
    Dose 4 — Moderna
  33. 2022-05-06
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  34. 2022-05-07
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  35. 2022-05-08
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  36. 2022-05-09
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  37. 2022-05-10
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  38. 2022-05-11
    Survey response — day 7, dose 4
    MedDRA: No adverse event — Feeling: Good
    Free text: No
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-05-18
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-05-25
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-06-01
    Survey response — day 28, dose 4
    MedDRA: Pre-existing disease — Feeling: Fair
    Free text: Alergies
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-06-08
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-06-15
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  44. 2022-08-03
    Survey response — 3 months, dose 4
    MedDRA: Weight decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: I lost 30 pounds the first 3 months of this year. After several tests there is no medical reason for this. I have maintained 145 pounds since April.
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-08-03
    Report sent to call center — 3 months, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  46. 2022-08-04
    Call successful
    Not applicable - Accidental Reporting
  47. 2022-11-02
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in
  48. 2023-05-04
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-22Moderna
22021-02-24Moderna
32021-11-11Moderna No
42022-05-04Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-08-03 Successful
2022-08-04
 Not applicable - Accidental Reporting

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Runny nose

Release 5 — day 14, dose 2

2021-03-10

Symptoms: My face gets red and I get hot. I do not have a fever.

Release 7 — day 42, dose 2

2021-04-07

Symptoms: A lot of coughing on Monday. May have been due to pollen. Had some mild pain in my chest yesterday, last night and now. No idea what that is.

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Breathing problems that I attribute to the humidity. I have had these symptoms for use in high humidity.

Release 11 — day 7, dose 4

2022-05-11

Systemic reaction (other): No

Release 11 — day 28, dose 4

2022-06-01

Symptoms: Alergies

Release 12 — 3 months, dose 4

2022-08-03

Symptoms: I lost 30 pounds the first 3 months of this year. After several tests there is no medical reason for this. I have maintained 145 pounds since April.

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
SDChest pain ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDFeeling hot ✓ ✓ ✓
SDPre-existing disease ✓ · ✓
SDWeight decreased · · ✓
SRONo adverse event · · ✓
SRORhinorrhoea ✓ ✓ ✓

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

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