YVA-16155-41115
4 vaccinations
4 coded responses
51 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 015 / MA
- Registered
- 2021-04-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-07
Registered in v-safe
-
2021-04-07
Dose 1 — Moderna
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-28
-
2021-05-05
Dose 2 — Moderna
- 2021-05-05
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-16
- 2021-08-04
- 2021-11-03
-
2021-11-19
Dose 3 — Moderna
- 2021-11-19
-
2021-11-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-11-25
- 2021-11-26
-
2021-12-03
Survey response — day 14, dose 3MedDRA: Chest pain, Emergency care, Influenza virus test negative, Myalgia, Peripheral swelling, Pyrexia, SARS-CoV-2 test negative, Urticaria — 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 consultation, Emergency room or emergency department visitFree text: Starting on Sunday, I developed hives, sore muscles in my limbs, intermittent fever, brief chest pain, and swollen hands and feet. I was seen in the emergency room on Tuesday, where they ruled out COVID or flu infection and myocarditis.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-03
Report sent to call center — day 14, dose 3Be 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 · Emergency room or emergency department visit · 1 call case(s)
-
2021-12-06
Call successfulParticipant prefers to complete VAERS report online
-
2021-12-10
Survey response — day 21, dose 3MedDRA: Nausea, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Nausea and vomiting on MondayMedDRA releases: 2024-11 · check-in free text available
- 2021-12-17
- 2021-12-24
- 2021-12-31
- 2022-02-18
- 2022-05-20
-
2022-09-09
Dose 4 — Pfizer-BioNTech
- 2022-09-09
-
2022-09-10
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-11
- 2022-09-12
- 2022-09-16
-
2022-09-25
Survey response — day 14, dose 4MedDRA: Conjunctivitis, Nasopharyngitis, Paranasal sinus discomfort — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Conjunctivitis, cold symptoms, sinus pressureMedDRA releases: 2024-11 · check-in free text available
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
-
2022-12-09
Survey response — 3 months, dose 4MedDRA: Cough, Nasopharyngitis, Rhinorrhoea — Feeling: GoodFree text: Cold like symptoms: runny nose progressing to cough. Likely came from daughter, a toddler who attends daycare. She tested neg for COVID, flu and RSV.MedDRA releases: 2024-11 · check-in free text available
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-07 | Moderna | |
| 2 | 2021-05-05 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-09-09 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-03 | Successful 2021-12-06 |
Participant prefers to complete VAERS report online |
Free text
Release 10 — day 14, dose 3
Symptoms: Starting on Sunday, I developed hives, sore muscles in my limbs, intermittent fever, brief chest pain, and swollen hands and feet. I was seen in the emergency room on Tuesday, where they ruled out COVID or flu infection and myocarditis.
Release 10 — day 21, dose 3
Symptoms: Nausea and vomiting on Monday
Release 12 — day 14, dose 4
Symptoms: Conjunctivitis, cold symptoms, sinus pressure
Release 12 — 3 months, dose 4
Symptoms: Cold like symptoms: runny nose progressing to cough. Likely came from daughter, a toddler who attends daycare. She tested neg for COVID, flu and RSV.
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 | Chest pain | · | · | ✓ |
| SD | Conjunctivitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release