YFY-30344-72904
2 vaccinations
3 coded responses
24 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 490 / MI
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
-
2021-01-15
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-17
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Nausea — Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness, NauseaFree text: I noticed that the onset of nausea and headache occurs after eating and goes away about a half hour laterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-20
- 2021-01-21
- 2021-01-22
-
2021-01-29
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash, Paraesthesia — Feeling: GoodFree text: The injection site became really itchy the morning of 1/25 and I noticed a rash in that area, but the rash went away a couple of days later. Also, i noticed some tingling in my arm and some of my fingers.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
- 2021-02-12
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · DiarrheaAdult check-in
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-14
- 2021-03-19
- 2021-03-26
- 2021-05-15
-
2022-02-12
Survey response — 12 months, dose 2MedDRA: Chest pain, Office visit, Palpitations, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Unexplained heart palpitations, chest pain and skin rash. All symptoms cleared up on their own. · Healthcare visit (other): Health consultations with my primary care physician, cardiogist and dermatologistMedDRA releases: 2024-11 · check-in free text available
-
2022-02-12
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-02-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-12 | Successful 2022-02-17 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I noticed that the onset of nausea and headache occurs after eating and goes away about a half hour later
Release 3 — day 14, dose 1
Symptoms: The injection site became really itchy the morning of 1/25 and I noticed a rash in that area, but the rash went away a couple of days later. Also, i noticed some tingling in my arm and some of my fingers.
Release 11 — 12 months, dose 2
Symptoms: Unexplained heart palpitations, chest pain and skin rash. All symptoms cleared up on their own.
Healthcare visit (other): Health consultations with my primary care physician, cardiogist and dermatologist
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 | Chest pain | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release