YRX-98141-99552
1 vaccination
2 coded responses
8 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 108 / NY
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
- 2021-01-17
-
2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Defaecation urgency, Irritable bowel syndrome, Unevaluable event — Feeling: Good · Chills, Headache, Muscle or body achesFree text: Bowel urgency, but NOT diarrhea. Also, CHILLS are mostly at night. My strength is better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-29
-
2022-01-15
Survey response — 12 months, dose 1MedDRA: Dysphonia, Fatigue, Medical counselling, Oropharyngeal pain, Respiratory tract congestion, 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: Symptoms: I tested positive on a rapid / home COVID-19 test (manufactured by: Quidel) it was called, "QUICKVUEAt-Home OTC COVID-19 Test". I tested positive (+) on 12/28/2021, after more than a week of congestion, raspy (mild) sore throat & continuous fatigu. · Healthcare visit (other): Telephone call to my MD. He prescribed a strong antibiotic (Zrithromicyn) 500mg/day; for 7 days.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-15
Report sent to call center — 12 months, dose 1Be 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)
-
2022-01-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-15 | Successful 2022-01-18 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Bowel urgency, but NOT diarrhea. Also, CHILLS are mostly at night. My strength is better today.
Release 10 — 12 months, dose 1
Symptoms: I tested positive on a rapid / home COVID-19 test (manufactured by: Quidel) it was called, "QUICKVUEAt-Home OTC COVID-19 Test". I tested positive (+) on 12/28/2021, after more than a week of congestion, raspy (mild) sore throat & continuous fatigu. cut off by CDC
Healthcare visit (other): Telephone call to my MD. He prescribed a strong antibiotic (Zrithromicyn) 500mg/day; for 7 days.
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 | Medical counselling | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Defaecation urgency | ✓ | · | ✓ |
| SRO | Irritable bowel syndrome | ○ | ✓ | ○ |
| SRO | Unevaluable event | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release