YM9-94812-36515
4 vaccinations
6 coded responses
47 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 310 / GA
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
- 2021-02-14
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-28
- 2021-03-06
-
2021-03-13
Dose 2 — Moderna
- 2021-03-13
- 2021-03-14
-
2021-03-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-21
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-06-14
- 2021-09-11
-
2021-11-04
Dose 3 — Moderna
- 2021-11-04
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Chills, No reaction on previous exposure to drug, Pruritus — Feeling: Fair · Site: Itching · ChillsFree text: No symptoms with the 1st or 2nd shot. Very surprised at the crazy itching and chills from the booster shot.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pruritus, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, DiarrheaFree text: The shot site is still itching like crazy. Using Benadryl itch stopping gel. It helps for a little while. I need to apply frequently because it itches so very much.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Pruritus — Feeling: Fair · Site: Redness, Swelling, Itching · HeadacheFree text: The redness was 3 inches yesterday and is 4 inches today. The itching has decreased from yesterday but the redness has grown.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · HeadacheAdult check-in
-
2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Injection site nodule — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Knot still at site. It's gone down a lot, but you can still see/feel it.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2022-02-03
-
2022-04-13
Dose 4 — Moderna
- 2022-04-19
- 2022-04-20
-
2022-04-27
Survey response — day 14, dose 4MedDRA: Cough, Headache, Insomnia, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I think everything is allergy related. Coughing non stop, headache, can't sleep Took covid test and it was negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-27
- 2022-07-13
-
2022-10-12
Survey response — 6 months, dose 4MedDRA: Accident, Malaise, Skin indentation, Suture insertion — Feeling: PoorFree text: My symptoms are NOT COVID related. I had an accident. I wound up with 3 sutures and 3 stalls in the back of my head. I don't feel well because of this. No issues with the COVID booster shot .MedDRA releases: 2024-11 · check-in free text available
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-13 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No symptoms with the 1st or 2nd shot. Very surprised at the crazy itching and chills from the booster shot.
Systemic reaction (other): The shot site is still itching like crazy. Using Benadryl itch stopping gel. It helps for a little while. I need to apply frequently because it itches so very much.
Systemic reaction (other): The redness was 3 inches yesterday and is 4 inches today. The itching has decreased from yesterday but the redness has grown.
Systemic reaction (other): Knot still at site. It's gone down a lot, but you can still see/feel it.
Release 11 — day 14, dose 4
Symptoms: I think everything is allergy related. Coughing non stop, headache, can't sleep Took covid test and it was negative
Release 12 — 6 months, dose 4
Symptoms: My symptoms are NOT COVID related. I had an accident. I wound up with 3 sutures and 3 stalls in the back of my head. I don't feel well because of this. No issues with the COVID booster shot .
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 | Accident | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Skin indentation | · | · | ✓ |
| SD | Suture insertion | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Injection site nodule | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | No reaction on previous exposure to drug | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release