YYV-96017-66871
5 vaccinations
7 coded responses
45 check-ins
6 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 577 / SD
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
-
2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy, Medical counselling — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I have a swollen, tender node by my left clavical. Movable. · Healthcare visit (other): Telephone consult today, appointment tomorrow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Lymph node swelling and tenderness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
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2021-04-27
Survey response — 3 months, dose 2MedDRA: Chest pain, Hospitalisation, Hypertension — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Admitted to hospital with chest pain. Negative stress test. New diagnosis of hypertension.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Report sent to call center — 3 months, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-19
- 2021-07-26
-
2021-11-01
Dose 3 — Moderna
- 2022-01-25
-
2022-04-24
Dose 4 — Pfizer-BioNTech
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2022-04-26
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Swelling · Muscle or body achesFree text: Node near my clavical on the left became enlarged to 2 mm ball - painful to touch. Swelling gone now.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-27
- 2022-04-28
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-10
- 2022-05-15
- 2022-05-22
- 2022-05-29
- 2022-06-05
- 2022-07-24
-
2022-09-30
Dose 5 — Pfizer-BioNTechCo-administered: Flu
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2022-10-08
Health check-in — day 7, dose 5Feeling: Good · Site: Pain · Muscle or body aches, DiarrheaAdult check-in
- 2022-10-14
- 2022-10-21
- 2022-10-30
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2022-11-04
Survey response — day 35, dose 5MedDRA: Haematuria, Haemorrhage — Feeling: GoodFree text: Gross hematuria, no pain, no UTI. Culture negative. Bleeding stopped after 12 hours, and have been fine since then.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-11
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2022-12-30
Survey response — 3 months, dose 5MedDRA: Haematuria, Renal neoplasm, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Developed gross hematuria x 3 seperate events. Dx with a tumor on the top of my kidney. Scheduled for a partial nephrectomy on 1/16/23. · Healthcare visit (other): Cystoscopy and CT.MedDRA releases: 2024-11 · check-in free text available
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2022-12-30
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-04
- 2023-01-04
- 2023-01-04
- 2023-01-04
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2023-03-31
Survey response — 6 months, dose 5MedDRA: Haematuria, Hospitalisation, Nephrectomy, Renal hamartoma, Surgery — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · HospitalizationMedDRA releases: 2024-11
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2023-03-31
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2023-04-03
- 2023-04-03
- 2023-04-03
- 2023-04-03
- 2023-04-03
- 2023-04-06
- 2023-04-06
- 2023-04-06
- 2023-04-06
- 2023-04-06
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2023-04-06
Callback requested for02:00PM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-04-24 | Pfizer-BioNTech | No |
| 5 | 2022-09-30 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-28 | Unsuccessful | |
| 2021-01-29 | Unsuccessful | |
| 2021-04-27 | Unsuccessful | |
| 2022-12-30 | Unsuccessful | |
| 2023-03-31 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I have a swollen, tender node by my left clavical. Movable.
Healthcare visit (other): Telephone consult today, appointment tomorrow.
Systemic reaction (other): Lymph node swelling and tenderness.
Release 8 — 3 months, dose 2
Symptoms: Admitted to hospital with chest pain. Negative stress test. New diagnosis of hypertension.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Node near my clavical on the left became enlarged to 2 mm ball - painful to touch. Swelling gone now.
Release 12 — day 35, dose 5
Symptoms: Gross hematuria, no pain, no UTI. Culture negative. Bleeding stopped after 12 hours, and have been fine since then.
Release 12 — 3 months, dose 5
Symptoms: Developed gross hematuria x 3 seperate events. Dx with a tumor on the top of my kidney. Scheduled for a partial nephrectomy on 1/16/23.
Healthcare visit (other): Cystoscopy and CT.
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 | Hospitalisation | · | · | ✓ |
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Haematuria | · | · | ✓ |
| SD | Haemorrhage | · | · | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SD | Nephrectomy | · | · | ✓ |
| SD | Renal hamartoma | · | · | ✓ |
| SD | Renal neoplasm | · | · | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release