2AV-27502-97990

4 vaccinations 11 coded responses 37 check-ins 12 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 412 / KY
Registered: 2021-02-16

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

2021-02-15
Dose 1 — Moderna
2021-02-16
Registered in v-safe
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 14, dose 1
MedDRA: Cough, Fatigue, Respiratory tract congestion, Sinus congestion — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Congestion in chest and sinuses. Coughing. Fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-15
Dose 2 — Moderna
2021-03-15
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Nosebleeds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-29
Survey response — day 14, dose 2
MedDRA: Discomfort, Dyspnoea, Pain, Scab — Feeling: Good

Free text: A build up of scabs in my nostrils. To the point that I can barely breathe through my nose. Very uncomfortable and painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 21, dose 2
MedDRA: Nasal crusting — Feeling: Fair

Free text: A continuing build up of scabs inside both of my nostrils.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — day 28, dose 2
MedDRA: Office visit, Scab, Sinus congestion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus congestion with a build up of scabs in my nostrils had gotten worse. The problem started after the second shot. · Healthcare visit (other): Primary Care Physician Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Survey response — day 35, dose 2
MedDRA: Nasal crusting, Nasal septum disorder — Feeling: Poor · Be unable to do your normal daily activities

Free text: The scabbing in my nostrils has gotten better, but now I have a hole developing in my septum. Very concerning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 42, dose 2
MedDRA: Nasal cyst, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My nasal problem continued with it now being diagnosed as a cyst. · Healthcare visit (other): In office Primary Care Physician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-01
Dose 3 — Moderna
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2022-03-15
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in
2022-06-01
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in
2022-11-26
Dose 4 — Moderna
2022-12-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-12-01
Survey response — 12 months, dose 3
MedDRA: Chronic kidney disease, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Kidney disease stage three · Healthcare visit (other): PCP Visit

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Chills

Adult check-in
2022-12-02
Call 1 — Left Voicemail
2022-12-03
Health check-in — day 7, dose 4
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-12
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-12-17
Survey response — day 21, dose 4
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-24
Health check-in — day 28, dose 4
Feeling: Poor · Be unable to do your normal daily activities

Free text: Increasing fatigue

Adult check-in · check-in free text available
2022-12-31
Survey response — day 35, dose 4
MedDRA: Pollakiuria — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extremely frequent urination.

MedDRA releases: 2024-11 · check-in free text available
2023-01-08
Health check-in — day 42, dose 4
Feeling: Poor

Adult check-in
2023-02-27
Health check-in — 3 months, dose 4
Feeling: Poor

Adult check-in
2023-05-28
Health check-in — 6 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna
3	2021-12-01	Moderna	No
4	2022-11-26	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-22

Systemic reaction (other): Sore throat

Release 4 — day 14, dose 1

2021-03-01

Symptoms: Congestion in chest and sinuses. Coughing. Fatigue.

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Nosebleeds

Release 6 — day 14, dose 2

2021-03-29

Symptoms: A build up of scabs in my nostrils. To the point that I can barely breathe through my nose. Very uncomfortable and painful.

Release 7 — day 21, dose 2

2021-04-06

Symptoms: A continuing build up of scabs inside both of my nostrils.

Release 7 — day 28, dose 2

2021-04-12

Symptoms: Sinus congestion with a build up of scabs in my nostrils had gotten worse. The problem started after the second shot.

Healthcare visit (other): Primary Care Physician Visit

Release 7 — day 35, dose 2

2021-04-19

Symptoms: The scabbing in my nostrils has gotten better, but now I have a hole developing in my septum. Very concerning.

Release 7 — day 42, dose 2

2021-04-26

Symptoms: My nasal problem continued with it now being diagnosed as a cyst.

Healthcare visit (other): In office Primary Care Physician

Release 12 — 12 months, dose 3

2022-12-01

Symptoms: Kidney disease stage three

Healthcare visit (other): PCP Visit

Release 12 — day 21, dose 4

2022-12-17

Symptoms: Fatigue

Release 12 — day 28, dose 4

2022-12-24

Symptoms: Increasing fatigue

Release 12 — day 35, dose 4

2022-12-31

Symptoms: Extremely frequent urination.

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	Chronic kidney disease	·	·	✓
SD	Cough	✓	✓	✓
SD	Discomfort	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nasal crusting	✓	✓	✓
SD	Nasal cyst	✓	✓	✓
SD	Nasal septum disorder	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pollakiuria	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Scab	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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