YLZ-18157-84530
4 vaccinations
4 coded responses
52 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 123 / NY
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Moderna
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: Headache very early in the morning around 3:00am it started.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-05-28
- 2021-08-27
-
2021-10-24
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-07
- 2021-11-14
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2022-01-23
-
2022-04-20
Dose 4 — Moderna
- 2022-04-20
-
2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Injection site reaction, Musculoskeletal stiffness — Feeling: GoodFree text: Muscle stiffness at injection areaMedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
-
2022-06-01
Survey response — day 42, dose 4MedDRA: Dermatitis, Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Skin rash and inflammation on back, arms and legs for a year starting in May 2021. · Healthcare visit (other): Demitologist and AlergeristMedDRA releases: 2024-11 · check-in free text available
-
2022-06-01
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-06-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-07-20
Survey response — 3 months, dose 4MedDRA: Cough, Diarrhoea, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test positive, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore throat, cough, sneezing, mild fever, very loose bowel movements on Monday night and Tuesday morning Tested positive for Covid on Tuesday ( home test) had a PCR test Tuesday morning results are still pendingMedDRA releases: 2024-11 · check-in free text available
- 2022-10-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-01 | Successful 2022-06-02 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Headache very early in the morning around 3:00am it started.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Muscle stiffness at injection area
Release 11 — day 42, dose 4
Symptoms: Skin rash and inflammation on back, arms and legs for a year starting in May 2021.
Healthcare visit (other): Demitologist and Alergerist
Release 12 — 3 months, dose 4
Symptoms: Sore throat, cough, sneezing, mild fever, very loose bowel movements on Monday night and Tuesday morning Tested positive for Covid on Tuesday ( home test) had a PCR test Tuesday morning results are still pending
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 | Cough | · | · | ✓ |
| SD | Dermatitis | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | SARS-CoV-2 test | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | · | · | ✓ |
| SRO | Musculoskeletal stiffness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release