YJ6-30430-35549
4 vaccinations
4 coded responses
27 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 741 / OK
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-08
Registered in v-safe
- 2021-03-08
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Chills, Muscle or body achesAdult check-in
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body achesAdult check-in
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
-
2021-04-22
Survey response — day 21, dose 2MedDRA: Diarrhoea — Feeling: GoodFree text: Mild diarrhea yesterday (4/21).I can't confirm that has anything to do with the vaccination, but I don't experience this often.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
-
2021-09-30
Survey response — 6 months, dose 2MedDRA: Adverse reaction, Increased upper airway secretion, Respiratory tract congestion, Rhinorrhoea, Sinus headache, Sneezing — Feeling: GoodFree text: Typical Fall allergy symptoms: increased mucus in nose and throat. Occasional minor sinus headache or stuffy head. Sneezing on occasion, etc. No aches, pains, brain fog, fatigue, fever or loss of smell aste though.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Dose 3 — ModernaCo-administered: Flu
-
2022-04-01
Survey response — 12 months, dose 2MedDRA: Joint injury — Feeling: Good · 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: Knee injury in January.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-01
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-04
-
2022-04-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-06-10
Dose 4 — Moderna
- 2022-06-29
- 2022-07-01
- 2022-07-08
- 2022-07-17
- 2022-07-22
- 2022-09-13
-
2022-12-09
Survey response — 6 months, dose 4MedDRA: Nasopharyngitis, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: FairFree text: In the last week I've had a runny nose. Not bad and seems like a minor cold. Home COVID test negative yesterday.MedDRA releases: 2024-11 · check-in free text available
- 2023-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-19 | Moderna | Flu |
| 4 | 2022-06-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-01 | Successful 2022-04-04 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 7 — day 21, dose 2
Symptoms: Mild diarrhea yesterday (4/21).I can't confirm that has anything to do with the vaccination, but I don't experience this often.
Release 9 — 6 months, dose 2
Symptoms: Typical Fall allergy symptoms: increased mucus in nose and throat. Occasional minor sinus headache or stuffy head. Sneezing on occasion, etc. No aches, pains, brain fog, fatigue, fever or loss of smell aste though.
Release 11 — 12 months, dose 2
Symptoms: Knee injury in January.
Release 12 — 6 months, dose 4
Symptoms: In the last week I've had a runny nose. Not bad and seems like a minor cold. Home COVID test negative yesterday.
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 | Adverse reaction | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Increased upper airway secretion | · | · | ✓ |
| SD | Joint injury | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release