Y6C-26434-87300
3 vaccinations
5 coded responses
31 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 750 / TX
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Moderna
- 2020-12-30
-
2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Abdominal painAdult check-in
-
2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Chills, Abdominal painFree text: Possibly related to chronic GERDMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-02
- 2021-01-03
- 2021-01-04
-
2021-01-06
Survey response — day 7, dose 1MedDRA: Myalgia — Feeling: Good · Muscle or body achesFree text: Muscle painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-13
-
2021-01-20
Survey response — day 21, dose 1MedDRA: Anxiety, Ear deformity acquired — Feeling: GoodFree text: My ear lobes have developed some deformaties. I don't know if it is caused by the vaccine but I am very concerned about it. They cause my ears to protrude. I have not read of anyone else having side effects like this.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
-
2021-01-28
Dose 2 — Moderna
- 2021-01-28
-
2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Ear pain, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Pains in my right foot where the leg is attached. Lasted pretty much all night. Also pains that shot through my right ear.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-05
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-04-29
- 2021-07-30
-
2021-09-28
Dose 3 — Moderna
- 2021-10-24
- 2021-10-26
- 2021-11-02
- 2021-11-09
-
2021-12-28
Survey response — 3 months, dose 3MedDRA: Respiratory tract congestion — Feeling: GoodFree text: A little congestion.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-31
- 2022-10-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-09-28 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Possibly related to chronic GERD
Release 1 — day 7, dose 1
Systemic reaction (other): Muscle pain
Release 2 — day 21, dose 1
Symptoms: My ear lobes have developed some deformaties. I don't know if it is caused by the vaccine but I am very concerned about it. They cause my ears to protrude. I have not read of anyone else having side effects like this.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Pains in my right foot where the leg is attached. Lasted pretty much all night. Also pains that shot through my right ear.
Release 10 — 3 months, dose 3
Symptoms: A little congestion.
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 | Anxiety | ✓ | ✓ | ✓ |
| SD | Ear deformity acquired | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release