Y6J-11132-71900
4 vaccinations
7 coded responses
37 check-ins
7 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 565 / MN
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-30
Dose 1 — Moderna
-
2021-03-31
Registered in v-safe
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
-
2021-04-27
Dose 2 — Moderna
-
2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue — Feeling: Good · Site: PainFree text: 2nd shot was late afternoon 4/27/21. THAT afternoon I fell asleep early, skipped supper too. Some chills but slept through to morning and worked the next day without much problem other than a sore arm (skinny arms!). Okay Thurs too. This morning just a little wondering why no "early morning equipment check-in" which we guys always get, but expect that to get back to normal quickly!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-07-27
- 2021-10-26
-
2021-11-15
Dose 3 — ModernaCo-administered: Flu
-
2022-04-27
Survey response — 12 months, dose 2MedDRA: Adverse reaction, Emergency care, Nausea, Pre-existing disease, Pyrexia, SARS-CoV-2 test negative, Somnolence — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: One week ago, I felt nauseous with temp of 101.5F. Because I have a couple heart issues, I went to Essentia ER for COVID-19 test and blood work etc ALL NEGATIVE and felt MUCH better after sleeping most of the next day! Lucky guy! · Healthcare visit (other): Please see above! Felt better within 36 hrsMedDRA releases: 2024-11 · check-in free text available
-
2022-04-27
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-04-29
- 2022-05-02
-
2022-05-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-31
Dose 4 — Moderna
-
2022-06-01
Survey response — days 1–6 daily, dose 4MedDRA: Body temperature increased, Chills, Pain in extremity — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Fatigue or tirednessFree text: Shot received yesterday, arm was sore in the evening so I slept in my La-Z-Boy until about 1 AM. Went to bed after bathroom, still pretty sore and mild temp but moderate chills too, on a day in the 60s. I figure I'll be better tomorrow.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-02
Survey response — days 1–6 daily, dose 4MedDRA: Pain, Pain in extremity — Feeling: Good · Site: PainFree text: Much better today, no chills or low-grade fever to report. Arm still sore and hurts some to raise it, but I do have skinny arms so maybe tougher to give me a shot than a shot for a normal guy. Anyway, things are looking up!MedDRA releases: 2024-11 · check-in free text available
-
2022-06-03
Survey response — days 1–6 daily, dose 4MedDRA: Injection site warmth, Pain, Pain in extremity — Feeling: Good · Site: PainFree text: Injection spot staying real warm, and arm is still a little sore to raise it or lift with it, but getting better!MedDRA releases: 2024-11 · check-in free text available
-
2022-06-04
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction — Feeling: GoodFree text: Arm almost back to normal, nice busy day, I'm back in business! And not trying to be gross or crude BUT I'll add an extra check - the "early morning equipment check" any guy's equipment gives him - unless he's sick - has shown up yesterday & today!MedDRA releases: 2024-11 · check-in free text available
- 2022-06-05
- 2022-06-06
- 2022-06-07
- 2022-06-14
- 2022-06-21
- 2022-06-28
- 2022-07-05
- 2022-07-12
-
2022-08-30
Survey response — 3 months, dose 4MedDRA: Office visit, Sunburn — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Just mild sunburn. No meds, but I visited my nurse practitioner to discuss etc. Otherwise, feeling great.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-30
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-08-31
-
2022-08-31
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-29
- 2023-06-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-30 | Moderna | |
| 2 | 2021-04-27 | Moderna | |
| 3 | 2021-11-15 | Moderna | Flu |
| 4 | 2022-05-31 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-27 | Successful 2022-05-03 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-08-30 | Successful 2022-08-31 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): 2nd shot was late afternoon 4/27/21. THAT afternoon I fell asleep early, skipped supper too. Some chills but slept through to morning and worked the next day without much problem other than a sore arm (skinny arms!). Okay Thurs too. This morning just a little wondering why no "early morning equipment check-in" which we guys always get, but expect that to get back to normal quickly!
Release 11 — 12 months, dose 2
Symptoms: One week ago, I felt nauseous with temp of 101.5F. Because I have a couple heart issues, I went to Essentia ER for COVID-19 test and blood work etc ALL NEGATIVE and felt MUCH better after sleeping most of the next day! Lucky guy!
Healthcare visit (other): Please see above! Felt better within 36 hrs
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Shot received yesterday, arm was sore in the evening so I slept in my La-Z-Boy until about 1 AM. Went to bed after bathroom, still pretty sore and mild temp but moderate chills too, on a day in the 60s. I figure I'll be better tomorrow.
Systemic reaction (other): Much better today, no chills or low-grade fever to report. Arm still sore and hurts some to raise it, but I do have skinny arms so maybe tougher to give me a shot than a shot for a normal guy. Anyway, things are looking up!
Systemic reaction (other): Injection spot staying real warm, and arm is still a little sore to raise it or lift with it, but getting better!
Systemic reaction (other): Arm almost back to normal, nice busy day, I'm back in business! And not trying to be gross or crude BUT I'll add an extra check - the "early morning equipment check" any guy's equipment gives him - unless he's sick - has shown up yesterday & today! cut off by CDC
Release 12 — 3 months, dose 4
Symptoms: Just mild sunburn. No meds, but I visited my nurse practitioner to discuss etc. Otherwise, feeling great.
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 | Adverse reaction | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Sunburn | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release