YZ3-10538-80865
4 vaccinations
3 coded responses
44 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 171 / PA
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 1 — Moderna
- 2021-04-08
-
2021-04-09
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Pain, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to workFree text: My shot was given about 7:30 in the morning. Symptoms started developing between 1030 and 11 oclock last night. Symptoms included severe chills and bodyaches. Fever was today in the morning started but broke about that in the morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-05-10
Dose 2 — Moderna
-
2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Injection site pain — Feeling: Good · Be unable to workFree text: On day of vaccination 12 hours after vaccination experienced chills and fever soreness at vaccination site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-25
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-06-21
- 2021-08-09
- 2021-11-08
-
2021-12-03
Dose 3 — Moderna
-
2021-12-03
Survey response — day 0, dose 3MedDRA: Injection site pain — Feeling: FairFree text: Very slight pain so far at injection point vaccinated at 9:40 a.m.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-04
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-09
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-01-15
- 2022-03-04
- 2022-06-03
-
2022-10-03
Dose 4 — Moderna
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2023-01-02
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna | |
| 2 | 2021-05-10 | Moderna | |
| 3 | 2021-12-03 | Moderna | No |
| 4 | 2022-10-03 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): My shot was given about 7:30 in the morning. Symptoms started developing between 1030 and 11 oclock last night. Symptoms included severe chills and bodyaches. Fever was today in the morning started but broke about that in the morning
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): On day of vaccination 12 hours after vaccination experienced chills and fever soreness at vaccination site.
Release 10 — day 0, dose 3
Systemic reaction (other): Very slight pain so far at injection point vaccinated at 9:40 a.m.
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 |
|---|---|---|---|---|
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release