YTA-11511-45840
3 vaccinations
15 coded responses
40 check-ins
15 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 441 / OH
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-19
Registered in v-safe
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2021-03-19
Dose 1 — Moderna
- 2021-03-19
- 2021-03-20
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2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Part of other syndrome not related to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Symptoms related to other condition, not to injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Related to another health conditionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Related to prior illness, not vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Related to prior health conditionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Survey response — day 7, dose 1MedDRA: Adverse reaction — Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Related to prior illnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-09
- 2021-04-16
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2021-04-19
Dose 2 — Moderna
- 2021-04-19
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2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Fatigue or tirednessAdult check-in
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2021-04-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint painsAdult check-in
- 2021-04-23
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2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Probably related to another conditionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-25
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2021-04-26
Survey response — day 7, dose 2MedDRA: Unevaluable event — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Probably related to preexisting conditionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-05-31
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2021-07-19
Survey response — 3 months, dose 2MedDRA: Kidney infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Kidney infections, prob not relatedMedDRA releases: 2024-11 · check-in free text available
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2021-07-19
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-26
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2021-08-17
Dose 3 — Moderna
- 2021-08-17
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2021-08-18
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Nausea, DiarrheaFree text: Could be related to underlying conditionMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-19
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal painAdult check-in
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2021-08-20
Survey response — days 1–6 daily, dose 3MedDRA: Migraine, Pollakiuria — Feeling: Poor · Site: Pain, Itching · Headache, Joint pains · Be unable to do your normal daily activitiesFree text: Migraine, frequent urinationMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-21
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: May be related to other conditionsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-22
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Fair · Headache, Joint pains, Diarrhea · Be unable to do your normal daily activitiesFree text: Probably related to other conditionsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-23
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Fair · Headache, Joint pains, Abdominal painFree text: Prob related to other conditionsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-24
Survey response — day 7, dose 3MedDRA: Unevaluable event — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, NauseaFree text: Prob related to other conditionsMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-31
- 2021-09-07
- 2021-09-14
- 2021-09-21
- 2021-09-28
- 2021-11-16
- 2022-02-17
- 2022-08-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-19 | Moderna | |
| 3 | 2021-08-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-19 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Part of other syndrome not related to vaccine
Systemic reaction (other): Symptoms related to other condition, not to injection
Systemic reaction (other): Related to another health condition
Systemic reaction (other): Related to prior illness, not vaccine
Systemic reaction (other): Related to prior health condition
Release 6 — day 7, dose 1
Systemic reaction (other): Related to prior illness
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Probably related to another condition
Release 8 — day 7, dose 2
Systemic reaction (other): Probably related to preexisting condition
Release 9 — 3 months, dose 2
Symptoms: Kidney infections, prob not related
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Could be related to underlying condition
Systemic reaction (other): Migraine, frequent urination
Systemic reaction (other): May be related to other conditions
Systemic reaction (other): Probably related to other conditions
Systemic reaction (other): Prob related to other conditions
Release 9 — day 7, dose 3
Systemic reaction (other): Prob related to other conditions
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 | Kidney infection | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Migraine | ✓ | · | ✓ |
| SRO | Pollakiuria | ✓ | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release