YM8-12457-03954
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 028 / RI
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness, NauseaAdult check-in
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
-
2021-02-15
Survey response — day 21, dose 2MedDRA: Fatigue — Feeling: GoodFree text: FatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-04-26
Survey response — 3 months, dose 2MedDRA: Rash — Feeling: FairFree text: Rash. Not sure if from bug bites, weed allergens, or something elseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-26
Survey response — 6 months, dose 2MedDRA: Rash — Feeling: GoodFree text: Skin rash on my legs but I suspect it may be a chlorine rash. Initially I had it on my arms and abdomen as well. But I started taking an anti histamine and it seems to have helped.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2022-01-25
Survey response — 12 months, dose 2MedDRA: Burning sensation, Office visit, Pruritus — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Itching/scratching, burning sensation. Not sure if it is allergy to something or reaction to the vaccine. · Healthcare visit (other): Primary care physician, dermatologist, allergistMedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-25 | Unsuccessful |
Free text
Release 4 — day 21, dose 2
Symptoms: Fatigue
Release 8 — 3 months, dose 2
Symptoms: Rash. Not sure if from bug bites, weed allergens, or something else
Release 9 — 6 months, dose 2
Symptoms: Skin rash on my legs but I suspect it may be a chlorine rash. Initially I had it on my arms and abdomen as well. But I started taking an anti histamine and it seems to have helped.
Release 11 — 12 months, dose 2
Symptoms: Itching/scratching, burning sensation. Not sure if it is allergy to something or reaction to the vaccine.
Healthcare visit (other): Primary care physician, dermatologist, allergist
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 | Burning sensation | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release