Y6D-28803-35862
2 vaccinations
6 coded responses
20 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 275 / NC
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-08
Dose 1 — Moderna
-
2021-02-11
Registered in v-safe
-
2021-02-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body aches, NauseaAdult check-in
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-02
-
2021-03-08
Survey response — day 28, dose 1MedDRA: Productive cough — Feeling: GoodFree text: Productive coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Dose 2 — Moderna
-
2021-03-15
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: Its been less than an hour since I got the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain — Feeling: Fair · Site: PainFree text: Chest pain not increased by moderate activityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Chest pain, Electrocardiogram normal, Heart rate increased, Immune system disorder, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Yesterday I referenced chest/back pain with attendant elevation of pulse rate during exercise. That is resolved. I had an EKG and it was normal. The working diagnosis is that it may be related to stress on my heart due to increased activity in my immune system. · Healthcare visit (other): Office visit with PCMMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-03-20
-
2021-03-22
Survey response — day 7, dose 2MedDRA: Rash, Rash erythematous — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Red rash on palms of both handsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-29
- 2021-04-05
-
2021-04-14
Survey response — day 28, dose 2MedDRA: Dyspnoea, Headache — Feeling: FairFree text: Headache, shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-26
- 2021-06-14
- 2021-12-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna | |
| 2 | 2021-03-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-17 | Unsuccessful |
Free text
Release 5 — day 28, dose 1
Symptoms: Productive cough
Release 5 — day 0, dose 2
Systemic reaction (other): Its been less than an hour since I got the shot.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Chest pain not increased by moderate activity
Systemic reaction (other): Yesterday I referenced chest/back pain with attendant elevation of pulse rate during exercise. That is resolved. I had an EKG and it was normal. The working diagnosis is that it may be related to stress on my heart due to increased activity in my immune system.
Healthcare visit (other): Office visit with PCM
Release 6 — day 7, dose 2
Systemic reaction (other): Red rash on palms of both hands
Release 7 — day 28, dose 2
Symptoms: Headache, shortness of breath
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Electrocardiogram normal | ○ | ✓ | ○ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Immune system disorder | ○ | ✓ | ○ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash erythematous | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release