2A9-90368-15332

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 280 / NC
Registered: 2020-12-29

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased, Muscle spasms — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Bad cramping. Also Glucose reading 350 for 24 hours. Going back down now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Itching · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Abdominal pain

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Abdominal pain

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — day 14, dose 2
MedDRA: Dysuria, Medical counselling — Feeling: Good

Free text: Having and issue with urinating also had this during first shot. Seems to go away within 2 weeks. Dr could not find any uti issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Survey response — day 35, dose 2
MedDRA: Platelet count decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Platelets are dropping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 42, dose 2
MedDRA: Platelet count decreased — Feeling: Fair · Be unable to work

Free text: Platelets still dropping down from 180 to 83

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — 3 months, dose 2
MedDRA: Platelet count decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Platelets dropped to 73. Dr monitoring not coming back up Started during first shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Call 1 — Left Voicemail
2021-06-04
Call 1 — Left Voicemail
2021-07-27
Survey response — 6 months, dose 2
MedDRA: Platelet count decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Low platelets

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Call 1 — Left Voicemail
2022-01-26
Survey response — 12 months, dose 2
MedDRA: Immune thrombocytopenia, Office visit, Platelet count decreased — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: ITP low platelets · Healthcare visit (other): Hematologist oncologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-27
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna

Call center

5 call center cases

4 successful · 1 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Bad cramping. Also Glucose reading 350 for 24 hours. Going back down now

Release 3 — day 14, dose 2

2021-02-09

Symptoms: Having and issue with urinating also had this during first shot. Seems to go away within 2 weeks. Dr could not find any uti issues

Release 4 — day 35, dose 2

2021-03-02

Symptoms: Platelets are dropping

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Platelets still dropping down from 180 to 83

Release 8 — 3 months, dose 2

2021-04-27

Symptoms: Platelets dropped to 73. Dr monitoring not coming back up Started during first shot.

Release 9 — 6 months, dose 2

2021-07-27

Symptoms: Low platelets

Release 11 — 12 months, dose 2

2022-01-26

Symptoms: ITP low platelets

Healthcare visit (other): Hematologist oncologist

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	Office visit	·	·	✓
SD	Dysuria	✓	✓	✓
SD	Immune thrombocytopenia	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Platelet count decreased	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓

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