YBL-42288-56387
3 vaccinations
7 coded responses
25 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 211 / MD
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-14
Dose 1 — Moderna
-
2021-04-15
Registered in v-safe
-
2021-04-15
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Pre-existing disease — Feeling: Good · Site: Pain · HeadacheFree text: I am beginning arthritis therapy so that may impact my reportingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Good · Site: ItchingFree text: Very very slight prickly itch on left wrist. Shot was right shouldetMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
-
2021-04-18
Survey response — days 1–6 daily, dose 1MedDRA: Back pain — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Experienced lower back pain today which I have not had for approximately 5 - 6 months. Did not do any thing strenuous to cause problem.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-19
Survey response — days 1–6 daily, dose 1MedDRA: Back pain — Feeling: GoodFree text: My lower back pain has returned after a 4 - 6 month pause??MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-20
-
2021-04-21
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Pretty good health todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
- 2021-05-05
-
2021-05-12
Dose 2 — Moderna
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-16
-
2021-06-23
Survey response — day 42, dose 2MedDRA: Lyme disease, Polymyalgia rheumatica — 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: Diagnosed with either Poly Mialga Rheumatica or Lyme diseaseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-23
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-01
-
2021-07-01
Call successfulOther
-
2021-08-11
Survey response — 3 months, dose 2MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nothing to do with COVID. Best medical move I could make. My medical issues are from arthritis,MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-25
Dose 3 — Moderna
- 2021-11-11
- 2021-11-12
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-04-25
- 2022-10-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-14 | Moderna | |
| 2 | 2021-05-12 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-23 | Successful 2021-07-01 |
Other |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): I am beginning arthritis therapy so that may impact my reporting
Systemic reaction (other): Very very slight prickly itch on left wrist. Shot was right shouldet
Systemic reaction (other): Experienced lower back pain today which I have not had for approximately 5 - 6 months. Did not do any thing strenuous to cause problem.
Systemic reaction (other): My lower back pain has returned after a 4 - 6 month pause??
Release 7 — day 7, dose 1
Systemic reaction (other): Pretty good health today
Release 9 — day 42, dose 2
Symptoms: Diagnosed with either Poly Mialga Rheumatica or Lyme disease
Release 9 — 3 months, dose 2
Symptoms: Nothing to do with COVID. Best medical move I could make. My medical issues are from arthritis,
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 | Lyme disease | ✓ | ✓ | ✓ |
| SD | Polymyalgia rheumatica | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release