YX3-14519-90680
2 vaccinations
6 coded responses
11 check-ins
6 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 435 / OH
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-06
Dose 1 — Moderna
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2021-01-13
Registered in v-safe
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2021-01-13
Survey response — day 7, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: GoodFree text: left supraclavicular lymph node swollen and tenderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — day 14, dose 1MedDRA: Rash, Rash erythematous — Feeling: GoodFree text: red rash to bilateral inner thighs that lasted two days and did not itch, burn, or cause painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — day 21, dose 1MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: sinusitisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-03
Dose 2 — Moderna
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2021-02-12
Health check-in — day 7, dose 2Feeling: Good · Site: Pain · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-02-17
Survey response — day 14, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: worsening pain and swelling in left supraclavicular lymph nodeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-17
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
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2021-04-23
Call successfulCompleted over the phone
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2021-05-05
Survey response — 3 months, dose 2MedDRA: Arthralgia, Imaging procedure, Magnetic resonance imaging normal, Neck pain, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: continued pain left shoulder/neck so Mri w lith contrast of neck soft tissue was done and was read as unremarkable · Healthcare visit (other): imagingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-05
Survey response — 6 months, dose 2MedDRA: Muscle contractions involuntary, Paraesthesia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: paraesthesias in hands and feet as well as muscle fasciculationsMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2022-04-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-27 | Successful | Completed over the phone |
| 2021-02-17 | Successful 2021-04-23 |
Completed over the phone |
| 2021-05-05 | Unsuccessful |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): left supraclavicular lymph node swollen and tender
Release 2 — day 14, dose 1
Symptoms: red rash to bilateral inner thighs that lasted two days and did not itch, burn, or cause pain
Release 2 — day 21, dose 1
Symptoms: sinusitis
Release 4 — day 14, dose 2
Symptoms: worsening pain and swelling in left supraclavicular lymph node
Release 8 — 3 months, dose 2
Symptoms: continued pain left shoulder/neck so Mri w lith contrast of neck soft tissue was done and was read as unremarkable
Healthcare visit (other): imaging
Release 9 — 6 months, dose 2
Symptoms: paraesthesias in hands and feet as well as muscle fasciculations
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 | Imaging procedure | ○ | ✓ | ○ |
| HCVO | Unevaluable event | ✓ | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Lymph node pain | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Magnetic resonance imaging normal | ○ | ✓ | ○ |
| SD | Muscle contractions involuntary | ✓ | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release