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24M-32984-03717

4 vaccinations 17 coded responses 45 check-ins 16 free-text entries 4 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
770 / TX
Registered
2021-01-16
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-16
    Registered in v-safe
  2. 2021-01-16
    Dose 1 — Moderna
  3. 2021-01-16
    Survey response — day 0, dose 1
    MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness
    Free text: Tiredness is not any more than usual
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Glossodynia, Swollen tongue — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Tongue swelling pain is now minimal
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Diarrhea
    Adult check-in
  6. 2021-01-22
    Survey response — days 1–6 daily, dose 1
    MedDRA: Constipation, Self-medication — Feeling: Good · Site: Pain
    Free text: Two days after I received the vaccination, I suffered constipation for 2 days. I thought that it might be a side effect of the vaccine; however, my urologist suggested taking lactulose, ehich helped correct the problem. Note: I have been taking MiraLax for months with out any constipation problems. So it was a surprise to me two days after the vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-23
    Health check-in — day 7, dose 1
    Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-01-30
    Survey response — day 14, dose 1
    MedDRA: Atrial fibrillation, Blood pressure increased, Emergency care, Gastrooesophageal reflux disease, Respiratory rate increased — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: I sleep upright on my couch due to acid reflux. Friday 3AM I woke up with rapid breathing. A nurse told me to go to ER. I did thinking COVID, but all it was ... was an unusual afib attack. BP was 150/80, and now it is about 110/60. It was not COVID
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-30
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-02-07
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-13
    Survey response — day 28, dose 1
    MedDRA: Oropharyngeal pain — Feeling: Good
    Free text: Infrequent sore throat that has happened numerous times since this past April, but after taking a sip of baby Claritin syrup, the sore throat vanishes with a good night sleep. What typically activates this condition is when I go shopping in a crowd.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-19
    Dose 2 — Moderna
  13. 2021-02-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling hot — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea
    Free text: I feel hot, but my temp is only 70°F
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  15. 2021-02-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: I sleep very good ... last night I had a sore throat, but now it is gone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cognitive disorder, Condition aggravated, Pre-existing disease — Feeling: Good · Fatigue or tiredness
    Free text: Mental health stress ... at the moment , slight
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  18. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  19. 2021-02-26
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-05
    Survey response — day 14, dose 2
    MedDRA: Rash — Feeling: Good
    Free text: I have had for many days, a rash on my hands, and did not associate this rash with Moderna until I read an article yesterday showing photos . Im not upset ... to live during the virus situation, one has to take risks.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-03-12
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-19
    Survey response — day 28, dose 2
    MedDRA: Body temperature decreased, Hypersomnia, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: I went to a barbershop a few days ago. My morning forehead temp before this event was typically 97.0-97.3; now, it is 96.6, and I have a sore throat treated with Claritin baby syrup, which does the trick. Plus I seem to sleep more often than usual.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-03-26
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-03
    Survey response — day 42, dose 2
    MedDRA: Amnesia, Personality change — Feeling: Good · Be unable to do your normal daily activities
    Free text: Continual memory problems which I associated with old age, but now believe the downward spiral is associated with COVID, plus personality changes which may or may not be associated with COVID. Some activities, but not all activities.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-05-21
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-28
    Call successful
    Does not wish to fill out VAERS report
  27. 2021-08-20
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-10-26
    Dose 3 — Moderna
  29. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  30. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2021-11-09
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-11-16
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  33. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-11-30
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-01-25
    Survey response — 3 months, dose 3
    MedDRA: Abdominal pain, Back pain, Fatigue, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Tired Pain in lower back and abdomen · Healthcare visit (other): Tomorrow, a CAT scan
    MedDRA releases: 2024-11 · check-in free text available
  37. 2022-01-25
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  38. 2022-01-26
  39. 2022-04-26
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-10-10
    Dose 4 — Moderna
    Co-administered: Flu
  41. 2022-10-10
    Health check-in — day 0, dose 4
    Feeling: Good · None
    Adult check-in
  42. 2022-10-11
    Survey response — days 1–6 daily, dose 4
    MedDRA: Pain — Feeling: Fair · Site: Pain, Swelling
    Free text: Sore this morning but now almost pain free
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-10-12
    Survey response — days 1–6 daily, dose 4
    MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Muscle or body aches
    Free text: Shoulder is sore
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-10-13
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Muscle or body aches
    Adult check-in
  45. 2022-10-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  46. 2022-10-16
    Survey response — days 1–6 daily, dose 4
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Abdominal pain
    Free text: I believe I have had a flare-up of Barrett's epithelium
    MedDRA releases: 2024-11 · check-in free text available
  47. 2022-10-17
    Survey response — day 7, dose 4
    MedDRA: Barrett's oesophagus, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Systemic reaction (other): Unexplained onset of Barrett's epithelium ? will see gastronomy doctor wednesday · Healthcare visit (other): Gastro doctor on wednesday
    MedDRA releases: 2024-11 · check-in free text available
  48. 2022-10-17
    Report sent to call center — day 7, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  49. 2022-10-18
  50. 2022-10-18
  51. 2022-10-24
    Health check-in — day 14, dose 4
    Feeling: Fair
    Adult check-in
  52. 2022-11-01
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  53. 2022-11-08
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  54. 2022-11-14
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  55. 2022-11-22
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  56. 2023-01-09
    Survey response — 3 months, dose 4
    MedDRA: Dyspnoea, Middle insomnia, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    MedDRA releases: 2024-11
  57. 2023-01-09
    Report sent to call center — 3 months, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  58. 2023-01-10
  59. 2023-01-10
  60. 2023-01-10
  61. 2023-04-11
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-16Moderna
22021-02-19Moderna
32021-10-26Moderna No
42022-10-10Moderna Flu

Call center

4 call center cases

1 successful · 3 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-16

Systemic reaction (other): Tiredness is not any more than usual

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Tongue swelling pain is now minimal

2021-01-22

Systemic reaction (other): Two days after I received the vaccination, I suffered constipation for 2 days. I thought that it might be a side effect of the vaccine; however, my urologist suggested taking lactulose, ehich helped correct the problem. Note: I have been taking MiraLax for months with out any constipation problems. So it was a surprise to me two days after the vaccine

Release 3 — day 14, dose 1

2021-01-30

Symptoms: I sleep upright on my couch due to acid reflux. Friday 3AM I woke up with rapid breathing. A nurse told me to go to ER. I did thinking COVID, but all it was ... was an unusual afib attack. BP was 150/80, and now it is about 110/60. It was not COVID cut off by CDC

Release 4 — day 28, dose 1

2021-02-13

Symptoms: Infrequent sore throat that has happened numerous times since this past April, but after taking a sip of baby Claritin syrup, the sore throat vanishes with a good night sleep. What typically activates this condition is when I go shopping in a crowd. cut off by CDC

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): I feel hot, but my temp is only 70°F

2021-02-22

Systemic reaction (other): I sleep very good ... last night I had a sore throat, but now it is gone.

2021-02-23

Systemic reaction (other): Mental health stress ... at the moment , slight

Release 5 — day 14, dose 2

2021-03-05

Symptoms: I have had for many days, a rash on my hands, and did not associate this rash with Moderna until I read an article yesterday showing photos . Im not upset ... to live during the virus situation, one has to take risks.

Release 5 — day 28, dose 2

2021-03-19

Symptoms: I went to a barbershop a few days ago. My morning forehead temp before this event was typically 97.0-97.3; now, it is 96.6, and I have a sore throat treated with Claritin baby syrup, which does the trick. Plus I seem to sleep more often than usual. cut off by CDC

Release 6 — day 42, dose 2

2021-04-03

Symptoms: Continual memory problems which I associated with old age, but now believe the downward spiral is associated with COVID, plus personality changes which may or may not be associated with COVID. Some activities, but not all activities.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Tired Pain in lower back and abdomen
Healthcare visit (other): Tomorrow, a CAT scan

Release 12 — days 1–6 daily, dose 4

2022-10-11

Systemic reaction (other): Sore this morning but now almost pain free

2022-10-12

Systemic reaction (other): Shoulder is sore

2022-10-16

Systemic reaction (other): I believe I have had a flare-up of Barrett's epithelium

Release 12 — day 7, dose 4

2022-10-17

Systemic reaction (other): Unexplained onset of Barrett's epithelium ? will see gastronomy doctor wednesday
Healthcare visit (other): Gastro doctor on wednesday

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event · · ✓
SDAbdominal pain · · ✓
SDAmnesia ✓ ✓ ✓
SDAtrial fibrillation ✓ ✓ ✓
SDBack pain · · ✓
SDBlood pressure increased ✓ ✓ ✓
SDBody temperature decreased ✓ ✓ ✓
SDDyspnoea · · ✓
SDEmergency care ✓ ✓ ✓
SDFatigue · · ✓
SDGastrooesophageal reflux disease ✓ ✓ ✓
SDHypersomnia ✓ ✓ ✓
SDMiddle insomnia · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPersonality change ✓ ✓ ✓
SDPre-existing disease · · ✓
SDRash ✓ ✓ ✓
SDRespiratory rate increased ✓ ✓ ✓
SROArthralgia · · ✓
SROBarrett's oesophagus · · ✓
SROCognitive disorder ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROConstipation ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFeeling hot ✓ ✓ ✓
SROGlossodynia ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPain · · ✓
SROPre-existing disease ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROSwollen tongue ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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