2AH-15773-17728
4 vaccinations
8 coded responses
41 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 063 / CT
- Registered
- 2021-02-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Dose 1 — Moderna
-
2021-02-22
Registered in v-safe
-
2021-02-22
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
-
2021-02-27
Health check-in — day 7, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-06
Survey response — day 14, dose 1MedDRA: Headache — Feeling: FairFree text: Daily headache, though, not severe (May not be directly associated with vaccine, as before vaccination, I stopped my daily anti inflammatory (Indocin) to ensure that my immune system was at full capacity).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
-
2021-03-20
Dose 2 — Moderna
-
2021-03-20
Survey response — day 0, dose 2MedDRA: Hypoaesthesia oral — Feeling: GoodFree text: Some numbness in lower lip, just like I experienced after first inoculationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · HeadacheAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-06-19
- 2021-09-20
-
2021-10-22
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-11-05
-
2021-11-12
Survey response — day 21, dose 3MedDRA: Eye pain, Headache — Feeling: FairFree text: Headache, very similar to the long-lasting headache after my second shot. The headache is most intense behind my eyes and extends across my skull to the crown area. Sometimes it is vey intense, other times relatively mild.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-20
- 2021-11-27
- 2021-12-03
- 2022-01-21
-
2022-04-12
Dose 4 — Moderna
- 2022-04-18
- 2022-04-20
-
2022-04-26
Survey response — day 14, dose 4MedDRA: Headache, Migraine with aura — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Several severe headaches, including a very severe migraine (with aura)MedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
-
2022-05-10
Survey response — day 28, dose 4MedDRA: Pruritus, Rash — Feeling: FairFree text: Rash and intense itching on the top of one foot. Nothing alleviates it. (This is similar, though, far less widespread, to what my wife has faced following her second vaccination, that intensified greatly after the first booster).MedDRA releases: 2024-11 · check-in free text available
-
2022-05-17
Survey response — day 35, dose 4MedDRA: Migraine, Pruritus — Feeling: FairFree text: Frequent migraines, in addition to the itching I reported last week.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
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2022-07-12
Survey response — 3 months, dose 4MedDRA: Neuropathy peripheral — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Neuropathy in right foot (toes and just behind toes)MedDRA releases: 2024-11 · check-in free text available
- 2022-10-11
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2023-04-12
Survey response — 12 months, dose 4MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
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2023-04-12
Report sent to call center — 12 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-13
-
2023-04-18
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-20 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — day 14, dose 1
Symptoms: Daily headache, though, not severe (May not be directly associated with vaccine, as before vaccination, I stopped my daily anti inflammatory (Indocin) to ensure that my immune system was at full capacity).
Release 6 — day 0, dose 2
Systemic reaction (other): Some numbness in lower lip, just like I experienced after first inoculation
Release 10 — day 21, dose 3
Symptoms: Headache, very similar to the long-lasting headache after my second shot. The headache is most intense behind my eyes and extends across my skull to the crown area. Sometimes it is vey intense, other times relatively mild.
Release 11 — day 14, dose 4
Symptoms: Several severe headaches, including a very severe migraine (with aura)
Release 11 — day 28, dose 4
Symptoms: Rash and intense itching on the top of one foot. Nothing alleviates it. (This is similar, though, far less widespread, to what my wife has faced following her second vaccination, that intensified greatly after the first booster).
Release 11 — day 35, dose 4
Symptoms: Frequent migraines, in addition to the itching I reported last week.
Release 12 — 3 months, dose 4
Symptoms: Neuropathy in right foot (toes and just behind toes)
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 |
|---|---|---|---|---|
| SD | COVID-19 | · | · | ✓ |
| SD | Eye pain | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Migraine with aura | · | · | ✓ |
| SD | Neuropathy peripheral | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release