YWJ-11279-73116
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 61-65
- ZIP prefix
- 731 / OK
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-21
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body achesFree text: But I'm old; this happens every so often.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-28
-
2021-02-04
Survey response — day 14, dose 1MedDRA: Respiratory tract congestion, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I think I've caught a cold. I have congestion. · Healthcare visit (other): I have a virtual appointment scheduled on Friday, the day after tomorrow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Headache, Joint painsAdult check-in
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-04
-
2021-06-29
Call successfulDoes not wish to fill out VAERS report
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Cough, Fatigue, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test positive, Sinus disorder — Feeling: GoodFree text: I was diagnosed positive for covid19 when I was tested on Aug 12, 2021. I felt like I had a mild cold. I had a mild sore throat, mild sinusy, mild cough. I felt tired.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2022-02-18
Survey response — 12 months, dose 2MedDRA: COVID-19, Cough, Dyspnoea, Fatigue, Malaise, SARS-CoV-2 test positive — Feeling: Good · 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, Outpatient clinic or urgent care clinic visitFree text: I had Covid again. I was sick starting Dec 27, 2021. I tested positive on Jan 5, 2022. I had a cough, shortness of breath, and very tired until Feb 5.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-18
Report sent to call center — 12 months, dose 2Be 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-04 | Successful 2021-06-29 |
Does not wish to fill out VAERS report |
| 2022-02-18 | Successful 2022-03-24 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): But I'm old; this happens every so often.
Release 3 — day 14, dose 1
Symptoms: I think I've caught a cold. I have congestion.
Healthcare visit (other): I have a virtual appointment scheduled on Friday, the day after tomorrow.
Release 9 — 6 months, dose 2
Symptoms: I was diagnosed positive for covid19 when I was tested on Aug 12, 2021. I felt like I had a mild cold. I had a mild sore throat, mild sinusy, mild cough. I felt tired.
Release 11 — 12 months, dose 2
Symptoms: I had Covid again. I was sick starting Dec 27, 2021. I tested positive on Jan 5, 2022. I had a cough, shortness of breath, and very tired until Feb 5.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | · | ✓ |
| SD | Sinus disorder | ✓ | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release