YYX-10459-00005
4 vaccinations
7 coded responses
36 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 787 / TX
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 2 — Moderna
- 2021-03-31
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-09
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-29
-
2021-11-01
Dose 3 — Moderna
-
2021-11-15
Survey response — day 14, dose 3MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: New rash that comes and goes on chest, back, scalp, neck, buttockMedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-16
-
2021-11-17
Call successfulCompleted over the phone
-
2021-11-23
Survey response — day 21, dose 3MedDRA: Breast feeding, Office visit, Rash, Self-medication — Feeling: FairFree text: Rash persists. Taking daily antihistamine beyond the 5 days recommended by dermatologist. Rash mostly controlled by antihistamine once a day. Not doing twice daily dosing because I am breastfeedingMedDRA releases: 2024-11 · check-in free text available
-
2021-11-29
Survey response — day 28, dose 3MedDRA: Rash, Self-medication — Feeling: FairFree text: Tried to stop antihistamine and was ok for 2 days but rash came back today, took Zyrtec 10 mgMedDRA releases: 2024-11 · check-in free text available
-
2021-12-06
Survey response — day 35, dose 3MedDRA: Loss of personal independence in daily activities, Rash pruritic, SARS-CoV-2 test negative, Self-medication, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend schoolFree text: Upper respiratory infection (not Covid, tested neg). Likely caught from daughter. Unable to do medical volunteering for 1 day Continued itchy rash intermittently- peaked back on Zyrtec to every other day or every third day but not completely goneMedDRA releases: 2024-11 · check-in free text available
-
2021-12-13
Survey response — day 42, dose 3MedDRA: Eye pruritus, Rash — Feeling: FairFree text: Itchy eyes in addition to rash that comes and goesMedDRA releases: 2024-11 · check-in free text available
- 2022-02-02
-
2022-05-02
Survey response — 6 months, dose 3MedDRA: Abortion spontaneous, Mole excision, Surgery, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Pregnancy and miscarriage at 12 weeks due to triploidy(69XXX), D&C Nevus removed with shave biopsy mild atypia · Healthcare visit (other): Outpatient surgical procedureMedDRA releases: 2024-11 · check-in free text available
-
2022-05-02
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-02
Dose 4 — Moderna
- 2022-12-02
-
2022-12-03
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-12-04
- 2022-12-05
- 2022-12-07
- 2022-12-08
- 2022-12-09
- 2022-12-16
- 2022-12-23
- 2022-12-30
- 2023-01-06
-
2023-01-13
Survey response — day 42, dose 4MedDRA: Cough, Laryngitis, SARS-CoV-2 test negative — Feeling: FairMedDRA releases: 2024-11
- 2023-03-03
- 2023-06-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-12-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-15 | Successful 2021-11-17 |
Completed over the phone |
| 2022-05-02 | Successful 2022-05-03 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — day 14, dose 3
Symptoms: New rash that comes and goes on chest, back, scalp, neck, buttock
Release 10 — day 21, dose 3
Symptoms: Rash persists. Taking daily antihistamine beyond the 5 days recommended by dermatologist. Rash mostly controlled by antihistamine once a day. Not doing twice daily dosing because I am breastfeeding
Release 10 — day 28, dose 3
Symptoms: Tried to stop antihistamine and was ok for 2 days but rash came back today, took Zyrtec 10 mg
Release 10 — day 35, dose 3
Symptoms: Upper respiratory infection (not Covid, tested neg). Likely caught from daughter. Unable to do medical volunteering for 1 day Continued itchy rash intermittently- peaked back on Zyrtec to every other day or every third day but not completely gone
Release 10 — day 42, dose 3
Symptoms: Itchy eyes in addition to rash that comes and goes
Release 11 — 6 months, dose 3
Symptoms: Pregnancy and miscarriage at 12 weeks due to triploidy(69XXX), D&C Nevus removed with shave biopsy mild atypia
Healthcare visit (other): Outpatient surgical procedure
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 | Abortion spontaneous | · | · | ✓ |
| SD | Breast feeding | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Laryngitis | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Mole excision | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SD | Uterine dilation and curettage | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release