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
-
2021-03-28
Dose 1 — Moderna
-
2021-04-22
Registered in v-safe
-
2021-04-22
Survey response — day 21, dose 1MedDRA: 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 visitFree 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, infectMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-25
-
2021-05-02
Survey response — day 35, dose 1MedDRA: Fatigue, Hypersomnia — Feeling: FairFree 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
- 2021-05-11
-
2021-06-28
Dose 2 — Moderna
-
2021-06-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-06-29
Survey response — 3 months, dose 1MedDRA: Back pain, Paraesthesia, Self-medication — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
- 2021-07-01
-
2021-07-02
Health check-in — days 1–6 daily, dose 2Feeling: 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 visitAdult check-in
-
2021-07-02
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-03
Survey response — days 1–6 daily, dose 2MedDRA: Injection site discomfort — Feeling: GoodFree text: Paperclip clings to point of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-04
- 2021-07-05
-
2021-07-13
Call successfulParticipant prefers to complete VAERS report online
- 2021-07-19
- 2021-07-26
- 2021-08-02
- 2021-08-09
- 2021-09-27
- 2021-12-28
- 2022-06-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-28 | Moderna | |
| 2 | 2021-06-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-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
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
Symptoms: Still have fatigue, tiredness, & just require extra sleep to recover from fatigue.
Release 9 — 3 months, dose 1
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypersomnia | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Injection site discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release