YRP-10147-77701

Timeline

1. 2021-03-25
   Registered in v-safe
2. 2021-03-25
   Dose 1 — Moderna
3. 2021-03-25
   Survey response — day 0, dose 1

   MedDRA: Dizziness, Hypotension, Immediate post-injection reaction, Loss of consciousness — Feeling: Poor · Site: Pain · Be unable to work, Be unable to do your normal daily activities

   Free text: About 13 minutes after the injection I suddenly became light headed and passed out. I awoke on the floor and had low blood pressure. I recovered after about 30 minutes.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
4. 2021-03-27
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

   Adult check-in
5. 2021-03-28
   Health check-in — days 1–6 daily, dose 1

   Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

   Adult check-in
6. 2021-03-29
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · None

   Adult check-in
7. 2021-03-30
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · Headache

   Adult check-in
8. 2021-03-31
   Health check-in — days 1–6 daily, dose 1

   Feeling: Good · Fatigue or tiredness

   Adult check-in
9. 2021-04-01
   Health check-in — day 7, dose 1

   Feeling: Good · None

   Adult check-in
10. 2021-04-09
    Survey response — day 14, dose 1

    MedDRA: Concussion, Disturbance in attention, Headache, Nausea, Syncope, Tinnitus — Feeling: Fair · Be unable to work

    Free text: I believe I sustained a concussion following a syncope episode during the observation period after my vaccine. I have had increasing headaches, difficulty concentrating, ringing in my ears and nausea. I assume these are concussion symptoms & not shot

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
11. 2021-04-15
    Health check-in — day 21, dose 1

    Feeling: Good

    Adult check-in
12. 2021-04-21
    Dose 2 — Moderna
13. 2021-04-22
    Health check-in — days 1–6 daily, dose 2

    Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

    Adult check-in
14. 2021-04-25
    Health check-in — days 1–6 daily, dose 2

    Feeling: Good · Headache

    Adult check-in
15. 2021-05-07
    Survey response — day 14, dose 2

    MedDRA: Concussion, Emergency care, Head banging, Head injury, Office visit, Pre-existing disease, Syncope, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

    Free text: Symptoms: Since my first dose I have had elevated tinnitus symptoms; I have always had tinnitus but it is considerably worse now. I also sustained a concussion after my first dose - I had a syncope episode and hit my head hard - so its unclear the cause. · Healthcare visit (other): I was taken to the ER after my first dose. I have had follow up on person appointments for the resulting symptoms.

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
16. 2021-05-07
    Report sent to call center — day 14, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
17. 2021-05-12
    Health check-in — day 21, dose 2

    Feeling: Fair

    Adult check-in
18. 2021-05-22
    Health check-in — day 28, dose 2

    Feeling: Good

    Adult check-in
19. 2021-05-26
    Health check-in — day 35, dose 2

    Feeling: Good

    Adult check-in
20. 2021-06-03
    Health check-in — day 42, dose 2

    Feeling: Good

    Adult check-in
21. 2021-07-21
    Health check-in — 3 months, dose 2

    Feeling: Good

    Adult check-in
22. 2021-10-20
    Health check-in — 6 months, dose 2

    Feeling: Good

    Adult check-in
23. 2022-01-07
    Call successful

    Participant prefers to complete VAERS report online