Y6P-58230-92659
5 vaccinations
9 coded responses
47 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · HeadacheAdult check-in
- 2021-01-22
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Nightmare, Poor quality sleep, Restlessness — Feeling: GoodFree text: Restless sleep, nightmaresMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Muscle spasms — Feeling: Fair · Muscle or body achesFree text: This note applies to yesterday, symptom check expired. Had an unusual severe lower leg muscle cramp during the night. Severity lessened after five minutes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-11
-
2021-02-17
Dose 2 — Moderna
- 2021-02-17
-
2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-19
- 2021-02-20
- 2021-02-21
-
2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteFree text: Itching is intermittant on upper arm below injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 28, dose 2MedDRA: Nightmare — Feeling: GoodFree text: Unusual for me to suffer so many nightmares during sleep, after second Moderna shot. Not sure why.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-05-19
- 2021-08-19
-
2021-10-23
Dose 3 — Moderna
- 2021-10-24
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Body temperature increased — Feeling: GoodFree text: Temp the morning after was 99.9 went away then came back at 99.6 for rest of day. No symptoms today!MedDRA releases: 2024-11 · check-in free text available
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-04-01
Dose 4 — Moderna
-
2022-04-14
Survey response — day 7, dose 4MedDRA: Body temperature increased — Feeling: Good · ChillsFree text: Slight temperature two weeks ago, 99.3FMedDRA releases: 2024-11 · check-in free text available
- 2022-04-15
-
2022-05-06
Survey response — day 35, dose 4MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: COVID positiveMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-05-09
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-14
- 2022-07-01
-
2022-09-19
Dose 5 — ModernaCo-administered: Flu
-
2022-09-30
Survey response — 6 months, dose 4MedDRA: Body temperature increased, COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing — Feeling: Good · Be unable to do your normal daily activitiesFree text: Second occurrence of COVID positive, first coughing symptoms appearing about six days after receiving simultaneous flu and bivalent Moderna boosters. Had usual mild coughing, sneezing, runny nose, and mild fever 99-100 degrees. Used home tests only.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
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2023-03-25
Survey response — 6 months, dose 5MedDRA: COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-09-19 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-06 | Successful 2022-05-09 |
Participant prefers to complete VAERS report online |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Restless sleep, nightmares
Systemic reaction (other): This note applies to yesterday, symptom check expired. Had an unusual severe lower leg muscle cramp during the night. Severity lessened after five minutes.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Itching is intermittant on upper arm below injection site.
Release 5 — day 28, dose 2
Symptoms: Unusual for me to suffer so many nightmares during sleep, after second Moderna shot. Not sure why.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Temp the morning after was 99.9 went away then came back at 99.6 for rest of day. No symptoms today!
Release 11 — day 7, dose 4
Systemic reaction (other): Slight temperature two weeks ago, 99.3F
Release 11 — day 35, dose 4
Symptoms: COVID positive
Release 12 — 6 months, dose 4
Symptoms: Second occurrence of COVID positive, first coughing symptoms appearing about six days after receiving simultaneous flu and bivalent Moderna boosters. Had usual mild coughing, sneezing, runny nose, and mild fever 99-100 degrees. Used home tests only. cut off by CDC
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 | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Nightmare | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Nightmare | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Restlessness | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release