Y5V-15377-35619
5 vaccinations
6 coded responses
27 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 029 / RI
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
- 2021-02-14
-
2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-02-17
Survey response — days 1–6 daily, dose 1MedDRA: Chest pain — Feeling: Fair · Fatigue or tirednessFree text: Heart acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Palpitations — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Heart palpitations when laying down or bent forwsrsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-20
-
2021-02-27
Survey response — day 14, dose 1MedDRA: Exercise tolerance decreased, Pyrexia, SARS-CoV-2 test negative, Viral infection — Feeling: Fair · Be unable to workFree text: Went for a jog and triggered 24 hour fever - most likely not related to Vaccine. Been suffering from post viral syndrome since March 2020 from Covid including low tolerance to exercise. Did get retested just in case and was negative.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-15
-
2021-03-18
Dose 2 — Moderna
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
-
2021-04-01
Survey response — day 14, dose 2MedDRA: Dyspepsia, Fatigue, Nausea — Feeling: FairFree text: Nausea, digestion issues, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
- 2021-04-15
-
2021-04-22
Survey response — day 35, dose 2MedDRA: Fatigue — Feeling: Fair · Be unable to workFree text: High level fatigue for two daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-06-17
-
2021-09-16
Survey response — 6 months, dose 2MedDRA: Chest pain, Condition aggravated, Head discomfort, Pre-existing disease — Feeling: Poor · Be unable to work or attend schoolFree text: Continue to have chest pain and head pressure from covid infection two years ago - it has slowly reduced - but got flu vaccine and it reactivated symptom intensity similar to covid vaccine - seems to be autoimmune issue or long covidMedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Dose 3 — Moderna
- 2022-06-10
-
2022-07-08
Dose 4 — Moderna
-
2022-10-07
Dose 5 — Moderna
-
2022-10-14
Health check-in — day 7, dose 5Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend schoolAdult check-in
- 2022-10-24
- 2023-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-18 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
| 4 | 2022-07-08 | Moderna | No |
| 5 | 2022-10-07 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Heart ache
Systemic reaction (other): Heart palpitations when laying down or bent forwsrs
Release 4 — day 14, dose 1
Symptoms: Went for a jog and triggered 24 hour fever - most likely not related to Vaccine. Been suffering from post viral syndrome since March 2020 from Covid including low tolerance to exercise. Did get retested just in case and was negative.
Release 6 — day 14, dose 2
Symptoms: Nausea, digestion issues, fatigue
Release 7 — day 35, dose 2
Symptoms: High level fatigue for two days
Release 9 — 6 months, dose 2
Symptoms: Continue to have chest pain and head pressure from covid infection two years ago - it has slowly reduced - but got flu vaccine and it reactivated symptom intensity similar to covid vaccine - seems to be autoimmune issue or long covid
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 | Chest pain | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Exercise tolerance decreased | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Head discomfort | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Viral infection | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release