YTR-53090-74173
4 vaccinations
5 coded responses
55 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness · Muscle or body achesAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 1MedDRA: Injection site bruising, Injection site discolouration, Injection site reaction, Injection site warmth, Rash, Rash erythematous — Feeling: GoodFree text: Nine days after my vaccination (3/12/2021) a 2 inch diameter red rash appeared below the injection site bruise that had faded to a yellowish tinge, but now had a brown smudge in the center. The rash did not itch and was warm to the touch. Gone now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
-
2021-03-31
Dose 2 — Moderna
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fever · Muscle or body achesAdult check-in
-
2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Chromaturia — Feeling: Good · Site: RednessFree text: Brown Urine Last Night And TodayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Chromaturia — Feeling: Good · Site: Pain, RednessFree text: Urine still brown but getting lighter in color and clearer.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Chromaturia — Feeling: Good · Site: RednessFree text: Urine last night was clear light brown with yellowish tint, today clear yellow with slight brown tint.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: Urine appears to be back to normal, straw or yellow and clear.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-29
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-11
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
- 2022-04-27
-
2022-05-16
Dose 4 — Moderna
- 2022-05-16
- 2022-05-17
- 2022-05-18
- 2022-05-19
- 2022-05-20
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-06-13
- 2022-06-20
- 2022-06-27
- 2022-08-15
- 2022-11-14
- 2023-05-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-05-16 | Moderna | No |
Free text
Release 5 — day 14, dose 1
Symptoms: Nine days after my vaccination (3/12/2021) a 2 inch diameter red rash appeared below the injection site bruise that had faded to a yellowish tinge, but now had a brown smudge in the center. The rash did not itch and was warm to the touch. Gone now. cut off by CDC
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Brown Urine Last Night And Today
Systemic reaction (other): Urine still brown but getting lighter in color and clearer.
Systemic reaction (other): Urine last night was clear light brown with yellowish tint, today clear yellow with slight brown tint.
Systemic reaction (other): Urine appears to be back to normal, straw or yellow and clear.
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 | Injection site bruising | ✓ | ✓ | ✓ |
| SD | Injection site discolouration | ✓ | · | ✓ |
| SD | Injection site reaction | ✓ | · | ✓ |
| SD | Injection site warmth | ✓ | · | ✓ |
| SD | Rash | ○ | ✓ | ○ |
| SD | Rash erythematous | ✓ | · | ✓ |
| SRO | Chromaturia | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release