YXF-32362-06159
5 vaccinations
7 coded responses
52 check-ins
7 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 722 / AR
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
-
2021-01-25
Dose 1 — Moderna
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
-
2021-02-08
Survey response — day 14, dose 1MedDRA: Dizziness, Dyspnoea, Pain in jaw — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Chest, jaw pain, shortness of breath, lightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-15
-
2021-02-22
Dose 2 — Moderna
- 2021-02-22
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
-
2021-03-29
Survey response — day 35, dose 2MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sore jointsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-05-24
- 2021-07-16
-
2021-08-23
Survey response — 6 months, dose 2MedDRA: Cyst removal, Subclavian vein thrombosis, Surgery — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Blood clot on shoulder was found when i was having a cyst surgically removed. · Healthcare visit (other): Outpatient surgeryMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-23
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-24
-
2021-10-25
Dose 3 — Moderna
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-05
Dose 4 — Moderna
-
2022-04-18
Survey response — day 7, dose 4MedDRA: Gait disturbance, Pain in extremity — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Difficult walking. Extreme pain in left legMedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Survey response — day 14, dose 4MedDRA: Arthralgia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Joint pain in legsMedDRA releases: 2024-11 · check-in free text available
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2022-04-26
Survey response — day 21, dose 4MedDRA: Arthralgia — 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 · Outpatient clinic or urgent care clinic visitFree text: Pain in leg jointsMedDRA releases: 2024-11 · check-in free text available
-
2022-04-26
Report sent to call center — day 21, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-28
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-07-05
-
2022-09-20
Dose 5 — Moderna
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2022-10-05
Survey response — 6 months, dose 4MedDRA: Arthralgia, Myalgia, Reaction to previous exposure to any vaccine — Feeling: FairFree text: Shoulder pain started 11 days after booster. It is in the opposite shoulder. I always get muscle pain approx 10 days after the shots and it lasts for several weeks.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-10
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-11-01
- 2022-12-20
- 2023-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-22 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-05 | Moderna | No |
| 5 | 2022-09-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-08 | Successful | Participant prefers to complete VAERS report online |
| 2021-08-23 | Successful | Participant prefers to complete VAERS report online |
| 2022-04-26 | Successful 2022-04-28 |
Participant prefers to complete VAERS report online |
Free text
Release 3 — day 14, dose 1
Symptoms: Chest, jaw pain, shortness of breath, lightheaded
Release 6 — day 35, dose 2
Symptoms: Sore joints
Release 9 — 6 months, dose 2
Symptoms: Blood clot on shoulder was found when i was having a cyst surgically removed.
Healthcare visit (other): Outpatient surgery
Release 11 — day 7, dose 4
Systemic reaction (other): Difficult walking. Extreme pain in left leg
Release 11 — day 14, dose 4
Symptoms: Joint pain in legs
Release 11 — day 21, dose 4
Symptoms: Pain in leg joints
Release 12 — 6 months, dose 4
Symptoms: Shoulder pain started 11 days after booster. It is in the opposite shoulder. I always get muscle pain approx 10 days after the shots and it lasts for several weeks.
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 | Surgery | ✓ | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Cyst removal | ✓ | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Subclavian vein thrombosis | ✓ | · | ✓ |
| SRO | Gait disturbance | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release