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Y9C-31187-83484

2 vaccinations 4 coded responses 18 check-ins 4 free-text entries 2 call cases
Sex
Male
Age at first dose
31-35
ZIP prefix
773 / TX
Registered
2021-04-22
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-28
    Dose 1 — Moderna
  2. 2021-04-22
    Registered in v-safe
  3. 2021-04-22
    Survey response — day 21, dose 1
    MedDRA: Cough, Fatigue, Office visit, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: 1st week I had a low grade fever that lasted for 6 days, then cough started 3 days after vaccine and lasted for 3 weeks. Tiredness and fatigue is still present. Went to my PCP, they did some blood work, and my liver AST = 130 and my ALT = 300, infect
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-22
    Report sent to call center — day 21, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  5. 2021-04-25
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-05-02
    Survey response — day 35, dose 1
    MedDRA: Fatigue, Hypersomnia — Feeling: Fair
    Free text: Still have fatigue, tiredness, & just require extra sleep to recover from fatigue.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-11
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-06-28
    Dose 2 — Moderna
  9. 2021-06-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  10. 2021-06-29
    Survey response — 3 months, dose 1
    MedDRA: Back pain, Paraesthesia, Self-medication — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Upper right back muscular pain in the rear right trap. Pain and tingling, but it goes away with Ibrufen.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-07-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-07-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Adult check-in
  13. 2021-07-02
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-07-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site discomfort — Feeling: Good
    Free text: Paperclip clings to point of injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-07-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-07-05
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-07-13
    Call successful
    Participant prefers to complete VAERS report online
  18. 2021-07-19
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-07-26
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-08-02
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-08-09
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-09-27
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-12-28
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2022-06-28
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-28Moderna
22021-06-28Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-22 Successful Participant prefers to complete VAERS report online
2021-07-02 Successful
2021-07-13
Participant prefers to complete VAERS report online

Free text

Release 7 — day 21, dose 1

2021-04-22

Symptoms: 1st week I had a low grade fever that lasted for 6 days, then cough started 3 days after vaccine and lasted for 3 weeks. Tiredness and fatigue is still present. Went to my PCP, they did some blood work, and my liver AST = 130 and my ALT = 300, infect cut off by CDC

Release 8 — day 35, dose 1

2021-05-02

Symptoms: Still have fatigue, tiredness, & just require extra sleep to recover from fatigue.

Release 9 — 3 months, dose 1

2021-06-29

Symptoms: Upper right back muscular pain in the rear right trap. Pain and tingling, but it goes away with Ibrufen.

Release 9 — days 1–6 daily, dose 2

2021-07-03

Systemic reaction (other): Paperclip clings to point of injection

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

FieldPreferred term2021-092023-042024-11
SDBack pain ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHypersomnia ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SROInjection site discomfort ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release