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YSY-56517-37797

5 vaccinations 9 coded responses 48 check-ins 9 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
493 / MI
Registered
2021-01-14
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-14
    Registered in v-safe
  2. 2021-01-14
    Dose 1 — Moderna
  3. 2021-01-14
    Survey response — day 0, dose 1
    MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  9. 2021-01-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-21
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-28
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-04
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-11
    Dose 2 — Moderna
  14. 2021-02-11
    Survey response — day 0, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache
    Free text: Head feels fuzzy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction, Fatigue — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness
    Free text: Had symptoms during night & tired today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthritis, Paraesthesia, Pre-existing disease — Feeling: Good · Headache
    Free text: I have had tingling on & off in my left index,middle fingers & thumb on & off for about 2 wks but didnt think it was relevant because i do have arthritis & could be carpal tunnel
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-02-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Paraesthesia, Pre-existing disease — Feeling: Good · Headache
    Free text: Still have slt tingling on & off left index & mid fingers & thumb but could be from my neck or carpal tunnel
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-02-18
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-02-25
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-04
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-03-25
    Survey response — day 42, dose 2
    MedDRA: Paraesthesia, Vitreous floaters — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Floaters in left eye & still have tingling on & off left index & mid fingersprimary dr thinks i have carpal tunnel & seeing ophthalmologist
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-03-25
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-05-13
    Survey response — 3 months, dose 2
    MedDRA: Carpal tunnel syndrome, Dysgeusia, Office visit, Vitreous floaters — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Bitter taste in mouthstill have n/tg left index &mid fingerdr thinks carpal tunnel & floater left eye · Healthcare visit (other): Primary care dr & opthalmoligistbiier taste started wed aftwr out of town trip & just go pcr test
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  29. 2021-05-13
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  30. 2021-08-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  31. 2021-10-22
    Dose 3 — Moderna
  32. 2021-10-26
    Survey response — days 1–6 daily, dose 3
    MedDRA: No adverse event — Feeling: Good
    Free text: No
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-10-27
    Survey response — days 1–6 daily, dose 3
    MedDRA: Feeling hot — Feeling: Good · Nausea
    Free text: Not sure if significant i was overheated & it went away once i cooled off
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-10-29
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-12
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-11-19
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-11-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-12-03
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-01-14
  42. 2022-01-21
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-03-31
    Dose 4 — Moderna
  44. 2022-04-18
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-04-21
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-04-28
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  47. 2022-05-05
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  48. 2022-05-12
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-06-30
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  50. 2022-09-04
    Dose 5 — Moderna
  51. 2022-09-22
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  52. 2022-09-25
    Health check-in — day 21, dose 5
    Feeling: Fair
    Adult check-in
  53. 2022-10-02
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  54. 2022-10-09
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  55. 2022-10-16
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  56. 2022-12-04
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  57. 2023-03-05
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-14Moderna
22021-02-11Moderna
32021-10-22Moderna No
42022-03-31Moderna No
52022-09-04Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-03-25 Unsuccessful
2021-05-13 Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-14

Systemic reaction (other): No

Release 4 — day 0, dose 2

2021-02-11

Systemic reaction (other): Head feels fuzzy

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Had symptoms during night & tired today

2021-02-16

Systemic reaction (other): I have had tingling on & off in my left index,middle fingers & thumb on & off for about 2 wks but didnt think it was relevant because i do have arthritis & could be carpal tunnel

2021-02-17

Systemic reaction (other): Still have slt tingling on & off left index & mid fingers & thumb but could be from my neck or carpal tunnel

Release 6 — day 42, dose 2

2021-03-25

Symptoms: Floaters in left eye & still have tingling on & off left index & mid fingersprimary dr thinks i have carpal tunnel & seeing ophthalmologist

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Bitter taste in mouthstill have n/tg left index &mid fingerdr thinks carpal tunnel & floater left eye
Healthcare visit (other): Primary care dr & opthalmoligistbiier taste started wed aftwr out of town trip & just go pcr test

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): No

2021-10-27

Systemic reaction (other): Not sure if significant i was overheated & it went away once i cooled off

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDCarpal tunnel syndrome ✓ ✓ ✓
SDDysgeusia ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SDVitreous floaters ✓ ✓ ✓
SROAdverse reaction ✓ ✓ ✓
SROArthritis ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROFeeling hot · · ✓
SRONo adverse event ✓ ✓ ✓
SROParaesthesia ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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