YUW-17667-63694
2 vaccinations
6 coded responses
22 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 531 / WI
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Dose 1 — Moderna
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2021-01-14
Registered in v-safe
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2021-01-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, DiarrheaAdult check-in
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: Pain, RednessFree text: Feel good. Spot on my arm is a sore. The first day after the shot I felt like I had the virus again.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-22
- 2021-01-29
- 2021-02-03
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2021-02-10
Dose 2 — Moderna
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2021-02-10
Survey response — day 0, dose 2MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, NauseaFree text: The area of the shot is hot. I can feel the temperature difference with my hand. Stomach feels a little funky, the way it felt a couple of days before I had tMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workAdult check-in
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Unevaluable event — Feeling: Good · Site: Pain · HeadacheFree text: First time I have felt like eating, and did, since getting the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
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2021-03-24
Survey response — day 42, dose 2MedDRA: Cough — Feeling: GoodFree text: I have a slight cough. I dont believe it is from COVID-19. The weather here has been cool and damp. Other than that I feel good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-13
Survey response — 3 months, dose 2MedDRA: Fatigue, Pulmonary congestion, Self-medication — Feeling: FairFree text: Lung congestion and tired. Taking Mucinex to reduce the phlegm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2022-02-10
Survey response — 12 months, dose 2MedDRA: Office visit, Productive cough, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Breathing and phlegm. · Healthcare visit (other): Appointment with my doctorMedDRA releases: 2024-11 · check-in free text available
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2022-02-10
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-10 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Feel good. Spot on my arm is a sore. The first day after the shot I felt like I had the virus again.
Release 4 — day 0, dose 2
Systemic reaction (other): The area of the shot is hot. I can feel the temperature difference with my hand. Stomach feels a little funky, the way it felt a couple of days before I had t
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): First time I have felt like eating, and did, since getting the shot.
Release 6 — day 42, dose 2
Symptoms: I have a slight cough. I dont believe it is from COVID-19. The weather here has been cool and damp. Other than that I feel good.
Release 8 — 3 months, dose 2
Symptoms: Lung congestion and tired. Taking Mucinex to reduce the phlegm.
Release 11 — 12 months, dose 2
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 | Office visit | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pulmonary congestion | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Decreased appetite | ✓ | · | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release