YBQ-12330-84732
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 109 / NY
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-02-08
- 2021-02-13
- 2021-02-20
-
2021-02-27
Dose 2 — Moderna
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Its possible I had a low grade fever for a while today, but not bad enough to justify taking my temperature.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-02
- 2021-03-05
- 2021-03-06
-
2021-03-13
Survey response — day 14, dose 2MedDRA: Nasal congestion, Office visit, Rhinalgia — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: About 5 days ago I began to experience soreness and a swelling in my left nostril. I saw my internist on March 11 who believes it might be a polyp and she prescribed medication. I will see and ENT dr on the 15th who will be able to get a better view · Healthcare visit (other): Doctors OfficeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-20
-
2021-03-27
Survey response — day 28, dose 2MedDRA: Hordeolum, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Stye in right eye · Healthcare visit (other): Doctors officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-03
- 2021-04-13
- 2021-05-29
- 2021-08-31
-
2021-12-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-13 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-03-27 | Successful 2021-12-21 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Its possible I had a low grade fever for a while today, but not bad enough to justify taking my temperature.
Release 5 — day 14, dose 2
Symptoms: About 5 days ago I began to experience soreness and a swelling in my left nostril. I saw my internist on March 11 who believes it might be a polyp and she prescribed medication. I will see and ENT dr on the 15th who will be able to get a better view cut off by CDC
Healthcare visit (other): Doctors Office
Release 6 — day 28, dose 2
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Hordeolum | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Rhinalgia | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release