YLJ-80198-89884
4 vaccinations
5 coded responses
35 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 112 / NY
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-27
- 2021-03-04
-
2021-03-11
Dose 2 — Moderna
- 2021-03-11
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Bad chills.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Good · FeverFree text: Fever peaked at 102F yesterday and overnight. By this morning, temp back to normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-15
- 2021-03-17
- 2021-03-20
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-06-10
- 2021-09-09
-
2021-09-27
Dose 3 — Moderna
- 2021-10-28
- 2021-11-01
- 2021-11-08
- 2021-12-27
- 2022-03-28
-
2022-04-05
Dose 4 — Janssen/Johnson & Johnson
-
2022-04-15
Survey response — day 7, dose 4MedDRA: Chills, Pyrexia — Feeling: GoodFree text: Had fever and chills for approx 36 hours after 4th shotMedDRA releases: 2024-11 · check-in free text available
-
2022-04-19
Survey response — day 14, dose 4MedDRA: Asthenia, Exposure to SARS-CoV-2, Fatigue, Pyrexia, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I was exposed to a Covid+ person on 4/13/22 and tested positive on 4/16/22. Was feverish 4/16-4/17 (high of 102.2). Was prescribed Paxlovid which I started taking evening of 4/16. Most symptoms have subsided, but am feeling tired and weak.MedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Report sent to call center — day 14, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-04-22
- 2022-04-26
- 2022-05-03
- 2022-05-10
-
2022-05-19
Survey response — day 42, dose 4MedDRA: Acupuncture, COVID-19, Pre-existing disease, Tremor — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Slight tremors post Covid/long Covid · Healthcare visit (other): AccupunctureMedDRA releases: 2024-11 · check-in free text available
-
2022-05-19
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-09-27 | Moderna | No |
| 4 | 2022-04-05 | Janssen/Johnson & Johnson | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-19 | Unsuccessful | |
| 2022-05-19 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Bad chills.
Systemic reaction (other): Fever peaked at 102F yesterday and overnight. By this morning, temp back to normal.
Release 11 — day 7, dose 4
Systemic reaction (other): Had fever and chills for approx 36 hours after 4th shot
Release 11 — day 14, dose 4
Symptoms: I was exposed to a Covid+ person on 4/13/22 and tested positive on 4/16/22. Was feverish 4/16-4/17 (high of 102.2). Was prescribed Paxlovid which I started taking evening of 4/16. Most symptoms have subsided, but am feeling tired and weak.
Release 11 — day 42, dose 4
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 | Acupuncture | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Tremor | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release