YX6-15496-96604
2 vaccinations
4 coded responses
19 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 223 / VA
- Registered
- 2021-09-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-29
Registered in v-safe
-
2021-09-29
Dose 1 — Moderna
-
2021-09-29
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-09-30
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: Soreness at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-10-01
-
2021-10-02
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Immediate post-injection reaction, Impaired work ability, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: I would make a retraction of my submitted status for the first day of vaccination. I am always sleepy but I was much more sleepy immediately after the COVID vaccination. I did not go into work for feeling to sleepy.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body achesAdult check-in
- 2021-10-04
-
2021-10-06
Health check-in — day 7, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-13
- 2021-10-20
- 2021-10-27
-
2021-10-29
Dose 2 — Moderna
- 2021-11-03
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
-
2022-01-28
Survey response — 3 months, dose 2MedDRA: Ageusia, Anosmia, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend schoolFree text: On December 22, 2021, I tested positive for Covid. Lost my sense of taste and smell for about two weeks. Tested negative on 15 January, 2022 with the PCR test.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-29 | Moderna | No |
| 2 | 2021-10-29 | Moderna | No |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): No
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Soreness at injection site
Systemic reaction (other): I would make a retraction of my submitted status for the first day of vaccination. I am always sleepy but I was much more sleepy immediately after the COVID vaccination. I did not go into work for feeling to sleepy.
Release 11 — 3 months, dose 2
Symptoms: On December 22, 2021, I tested positive for Covid. Lost my sense of taste and smell for about two weeks. Tested negative on 15 January, 2022 with the PCR test.
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 | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Impaired work ability | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release