YD9-17789-04713
4 vaccinations
6 coded responses
46 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 148 / NY
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
-
2021-03-11
Survey response — day 0, dose 1MedDRA: Paraesthesia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Slight tingling inside my ears for 5-10 minutes about 90 minutes after injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Body temperature decreased — Feeling: Good · Site: Pain · HeadacheFree text: Temperature was actually subnormal 96.2 F in two different thermometers.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Fair · Fever · ChillsFree text: The calls were from 10:39 PM yesterday to 2:30 AM today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-17
- 2021-03-18
-
2021-03-25
Survey response — day 14, dose 1MedDRA: Fatigue — Feeling: GoodFree text: More tired, and have had to lie down for 30 minutes usually mid to late afternoon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
- 2021-04-08
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2021-04-12
Dose 2 — Moderna
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Pain in extremity — Feeling: GoodFree text: I dont have symptoms now, but the day after my shot on 4/13/2021 I had chills but no fever, aches, headache, and tired plus sore arm (injected arm). All effects more severe than after my first shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-07-12
- 2021-10-11
-
2021-10-22
Dose 3 — Moderna
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2021-10-30
Survey response — day 7, dose 3MedDRA: Chillblains, Fatigue, Headache, Injection site pain, Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Oct. 22nd Booster at 10 am. 12 hours later I had serve chills, but no fever, and some arm pain. The next morning I had a mild headache and minor arm pain at the injection site & fatigue entire day. Fatigue on Oct. 24th.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
- 2021-11-21
- 2021-11-26
- 2021-12-03
- 2022-01-23
- 2022-04-24
-
2022-06-07
Dose 4 — Moderna
-
2022-06-08
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-06-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-06-10
- 2022-06-11
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2022-06-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2022-06-13
- 2022-06-14
- 2022-06-21
- 2022-06-28
- 2022-07-05
- 2022-07-12
- 2022-07-19
- 2022-09-06
- 2022-12-06
- 2023-06-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-12 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-06-07 | Moderna | No |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Slight tingling inside my ears for 5-10 minutes about 90 minutes after injection.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Temperature was actually subnormal 96.2 F in two different thermometers.
Systemic reaction (other): The calls were from 10:39 PM yesterday to 2:30 AM today.
Release 6 — day 14, dose 1
Symptoms: More tired, and have had to lie down for 30 minutes usually mid to late afternoon.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I dont have symptoms now, but the day after my shot on 4/13/2021 I had chills but no fever, aches, headache, and tired plus sore arm (injected arm). All effects more severe than after my first shot.
Release 10 — day 7, dose 3
Systemic reaction (other): Oct. 22nd Booster at 10 am. 12 hours later I had serve chills, but no fever, and some arm pain. The next morning I had a mild headache and minor arm pain at the injection site & fatigue entire day. Fatigue on Oct. 24th.
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 | Fatigue | ✓ | ✓ | ✓ |
| SRO | Body temperature decreased | ✓ | ✓ | ✓ |
| SRO | Chillblains | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release