YDA-14711-88892
4 vaccinations
11 coded responses
40 check-ins
10 free-text entries
5 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 890 / NV
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-23
-
2021-01-30
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site swelling — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Itchiness around injection site and slight swelling.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-06
Survey response — day 21, dose 1MedDRA: Seborrhoeic dermatitis, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Seborrheic Dermatitis - Dermatologist didnt think it was due to 1/16 vaccination, but wouldnt rule it out. Internist didnt think it was a side effect. I guess Ill find out after my second doseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-13
Dose 2 — Moderna
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
-
2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-02-19
-
2021-02-20
Survey response — day 7, dose 2MedDRA: Musculoskeletal stiffness — Feeling: Good · Joint pains, Fatigue or tirednessFree text: Stiff neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-03-06
- 2021-03-13
-
2021-03-20
Survey response — day 35, dose 2MedDRA: Fatigue — Feeling: GoodFree text: FatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
- 2021-05-15
- 2021-05-27
- 2021-06-03
-
2021-08-14
Survey response — 6 months, dose 2MedDRA: Blood glucose increased — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Increase in blood sugarMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-14
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-18
-
2021-10-26
Dose 3 — Moderna
- 2022-02-13
-
2022-03-31
Dose 4 — Moderna
- 2022-03-31
- 2022-04-01
-
2022-04-02
Survey response — days 1–6 daily, dose 4MedDRA: Condition aggravated, Pain in extremity, Pre-existing disease — Feeling: Good · Site: PainFree text: Flare up of diabetic neuropathy pain in toesMedDRA releases: 2024-11 · check-in free text available
- 2022-04-03
-
2022-04-04
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pruritus — Feeling: Good · Site: ItchingFree text: Itching at injection site is pretty annoying.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-05
- 2022-04-06
- 2022-04-07
- 2022-04-14
- 2022-04-21
- 2022-04-28
-
2022-05-05
Survey response — day 35, dose 4MedDRA: Blood glucose increased — Feeling: GoodFree text: Probably unrelated but my blood sugar has been high. One doctor thinks it's age related (75).MedDRA releases: 2024-11 · check-in free text available
-
2022-05-12
Survey response — day 42, dose 4MedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: flare up of seborrheic dermatitisMedDRA releases: 2024-11 · check-in free text available
-
2022-06-30
Survey response — 3 months, dose 4MedDRA: Eczema, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Eczema flare up.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-30
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-01
Call successfulDoes not wish to fill out VAERS report
- 2022-09-29
-
2023-03-31
Survey response — 12 months, dose 4MedDRA: Anaemia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-31
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-30 | Successful | Does not wish to fill out VAERS report |
| 2021-02-06 | Successful | Does not wish to fill out VAERS report |
| 2021-08-14 | Successful | Does not wish to fill out VAERS report |
| 2022-06-30 | Successful 2022-07-01 |
Does not wish to fill out VAERS report |
| 2023-03-31 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: Itchiness around injection site and slight swelling.
Release 3 — day 21, dose 1
Symptoms: Seborrheic Dermatitis - Dermatologist didnt think it was due to 1/16 vaccination, but wouldnt rule it out. Internist didnt think it was a side effect. I guess Ill find out after my second dose
Release 4 — day 7, dose 2
Systemic reaction (other): Stiff neck
Release 6 — day 35, dose 2
Symptoms: Fatigue
Release 9 — 6 months, dose 2
Symptoms: Increase in blood sugar
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Flare up of diabetic neuropathy pain in toes
Systemic reaction (other): Itching at injection site is pretty annoying.
Release 11 — day 35, dose 4
Symptoms: Probably unrelated but my blood sugar has been high. One doctor thinks it's age related (75).
Release 11 — day 42, dose 4
Symptoms: flare up of seborrheic dermatitis
Release 12 — 3 months, dose 4
Symptoms: Eczema flare up.
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 | Anaemia | · | · | ✓ |
| SD | Blood glucose increased | ✓ | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Eczema | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Seborrhoeic dermatitis | ✓ | ✓ | ✓ |
| SD | Specialist consultation | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release