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YJV-18373-55798

2 vaccinations 8 coded responses 15 check-ins 8 free-text entries 0 call cases
Sex
Male
Age at first dose
56-60
ZIP prefix
967 / HI
Registered
2021-04-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-30
    Dose 1 — Moderna
  2. 2021-04-29
    Dose 2 — Moderna
  3. 2021-04-30
    Registered in v-safe
  4. 2021-04-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  5. 2021-05-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  6. 2021-05-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: I routinely deal with low grade fevers, nausea, body aches, headaches etc due to (b)(6)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity, Pre-existing disease, Tenderness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Free text: I think these are the usual symptoms from (b)(6). Aside from sire arm and extra tiredness I think I'm past the vaccine side effects
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: I think items checked are from (b)(6) not vacvine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: The symptoms above are typical if my day fighting (b)(6). I do not believe I am having further vaccine effects
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-06
    Survey response — day 7, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: These are due to my (b)(6). I do not believe I am having vaccine side effects
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-13
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  12. 2021-05-20
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-05-28
    Survey response — day 28, dose 2
    MedDRA: Agitation, Anxiety — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Extreme agitation and anxiety, related to antidepressant I have been on for years
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-06-03
    Survey response — day 35, dose 2
    MedDRA: Anxiety, Dehydration, Panic attack — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Extreme anxiety and panic attacks probably unrelated you vaccine, but to Wellbutrin and dehydration
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-10
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  16. 2021-07-29
    Survey response — 3 months, dose 2
    MedDRA: Tooth infection — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Infected tooth
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  17. 2021-10-28
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  18. 2022-04-29
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-30Moderna
22021-04-29Moderna

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-02

Systemic reaction (other): I routinely deal with low grade fevers, nausea, body aches, headaches etc due to (b)(6)
redacted (b)(6)

2021-05-03

Systemic reaction (other): I think these are the usual symptoms from (b)(6). Aside from sire arm and extra tiredness I think I'm past the vaccine side effects
redacted (b)(6)

2021-05-04

Systemic reaction (other): I think items checked are from (b)(6) not vacvine
redacted (b)(6)

2021-05-05

Systemic reaction (other): The symptoms above are typical if my day fighting (b)(6). I do not believe I am having further vaccine effects
redacted (b)(6)

Release 8 — day 7, dose 2

2021-05-06

Systemic reaction (other): These are due to my (b)(6). I do not believe I am having vaccine side effects
redacted (b)(6)

Release 8 — day 28, dose 2

2021-05-28

Symptoms: Extreme agitation and anxiety, related to antidepressant I have been on for years

Release 8 — day 35, dose 2

2021-06-03

Symptoms: Extreme anxiety and panic attacks probably unrelated you vaccine, but to Wellbutrin and dehydration

Release 9 — 3 months, dose 2

2021-07-29

Symptoms: Infected tooth

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

FieldPreferred term2021-092023-042024-11
SDAgitation ✓ ✓ ✓
SDAnxiety ✓ ✓ ✓
SDDehydration ✓ ✓ ✓
SDPanic attack ✓ ✓ ✓
SDTooth infection ✓ · ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROTenderness ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release