2UY-77208-59406

2 vaccinations 13 coded responses 22 check-ins 13 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 016 / MA
Registered: 2021-01-21

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-20
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Urticaria — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Feeling of itchiness like hives around chest and neck. But skin looks fine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased, Pain in extremity — Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: #NAME?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Pain, Pain in extremity, Upper-airway cough syndrome — Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Free text: Random pains in fingers and side that run down towards groin. Started late thurs and less intense but still present. Also feel a sore throat thoat/post nasal drip but it may be unrelated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: #NAME?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Sensory disturbance — Feeling: Good · Joint pains

Free text: #NAME?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-10
Survey response — day 21, dose 1
MedDRA: Dizziness, Headache, Nausea — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: I have had headaches that at points have been severe with lightheadedness and nausea. Not sure if they are related to the vaccine or not, but I've never experienced them like this and I havent done anything different. They started on Friday 2/5/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Dose 2 — Moderna
2021-02-17
Survey response — day 0, dose 2
MedDRA: Hot flush, Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work

Free text: Itchiness in chest and neck | hot flashes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness

Free text: Itchiness in chest and neck but also now forearm of injection arm and back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Malaise — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Malaise general uneasiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — day 14, dose 2
MedDRA: Insomnia, Muscle spasms, Myalgia, Office visit — Feeling: Fair · 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: Symptoms: Severe insomnia and awful muscle cramps and pain · Healthcare visit (other): Worked with therapist on this new and severe insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 2
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)
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Pulmonary mass — Feeling: Good

Free text: Nodule in lung

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-18
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Fatigue, Pre-existing disease, Therapeutic response unexpected — Feeling: Fair · Be unable to do your normal daily activities

Free text: Random extreme exhaustion and fatigue and an increase in parasomnias even though my mental health has improved (historical trigger for these)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-23
Call successful
Participant prefers to complete VAERS report online
2022-02-17
Survey response — 12 months, dose 2
MedDRA: Fatigue, Malaise, Sleep terror — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Increased fatigue, sleep terrors, random severe malaise

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Feeling of itchiness like hives around chest and neck. But skin looks fine

2021-01-22

Systemic reaction (other): #NAME?

2021-01-23

Systemic reaction (other): Random pains in fingers and side that run down towards groin. Started late thurs and less intense but still present. Also feel a sore throat thoat/post nasal drip but it may be unrelated

2021-01-24

Systemic reaction (other): #NAME?

2021-01-25

Systemic reaction (other): #NAME?

Release 4 — day 21, dose 1

2021-02-10

Symptoms: I have had headaches that at points have been severe with lightheadedness and nausea. Not sure if they are related to the vaccine or not, but I've never experienced them like this and I havent done anything different. They started on Friday 2/5/21. cut off by CDC

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): Itchiness in chest and neck | hot flashes

Release 4 — days 1–6 daily, dose 2

2021-02-19

Systemic reaction (other): Itchiness in chest and neck but also now forearm of injection arm and back

2021-02-22

Systemic reaction (other): Malaise general uneasiness

Release 4 — day 14, dose 2

2021-03-03

Symptoms: Severe insomnia and awful muscle cramps and pain

Healthcare visit (other): Worked with therapist on this new and severe insomnia

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Nodule in lung

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: Random extreme exhaustion and fatigue and an increase in parasomnias even though my mental health has improved (historical trigger for these)

Release 11 — 12 months, dose 2

2022-02-17

Symptoms: Increased fatigue, sleep terrors, random severe malaise

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	Insomnia	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Malaise	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Pulmonary mass	✓	✓	✓
SD	Sleep terror	·	·	✓
SD	Therapeutic response unexpected	✓	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sensory disturbance	✓	·	✓
SRO	Upper-airway cough syndrome	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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