32M-17365-41417
5 vaccinations
10 coded responses
64 check-ins
9 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 989 / WA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
-
2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising, Pain in extremity — Feeling: Good · Site: Pain, Swelling · Muscle or body achesFree text: Sore arm, some bruising at injection site. MildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Ear pain, Oropharyngeal pain — Feeling: Good · Site: Pain, SwellingFree text: Had a slightly sore throat with some involvement of my ears last night, but that is subsidingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-02-07
- 2021-02-13
- 2021-02-20
-
2021-02-24
Dose 2 — Moderna
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia, Taste disorder — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Strange taste in mouth and change in food tasteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Mild soreness at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
-
2021-04-07
Survey response — day 42, dose 2MedDRA: Herpes zoster, Rash pruritic — Feeling: GoodFree text: Experienced what appeared to be a mild Shingles outbreak on my back and around waist. Have never had Shingles before and have had Shingles vaccines. The rash and itching seem to be subsiding. This actually occurred just prior to second Moderna shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-26
- 2021-08-26
-
2021-10-26
Dose 3 — ModernaCo-administered: Flu
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Dyspepsia — Feeling: GoodFree text: Have had indigestion for a couple days but not sure it is booster-relatedMedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
-
2021-11-10
Survey response — day 14, dose 3MedDRA: Cystitis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Serious bladder infectionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-10
Report sent to call center — day 14, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-12
- 2021-11-18
- 2021-11-23
- 2021-12-02
- 2021-12-07
- 2022-01-28
-
2022-04-19
Dose 4 — Moderna
- 2022-04-19
-
2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-25
- 2022-04-26
- 2022-05-04
- 2022-05-11
- 2022-05-17
- 2022-05-24
- 2022-06-01
- 2022-07-19
-
2022-10-18
Dose 5 — Moderna
- 2022-10-18
-
2022-10-20
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-21
-
2022-10-22
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Sore arm at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-10-24
- 2022-10-25
- 2022-11-01
- 2022-11-10
- 2022-11-17
- 2022-11-24
-
2022-11-30
Survey response — day 42, dose 5MedDRA: Cough, Influenza, Nasopharyngitis, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Feels like a cold or flu. Cough, sore throat, body aches, runny nose, congestion.MedDRA releases: 2024-11 · check-in free text available
-
2023-01-17
Survey response — 3 months, dose 5MedDRA: Malaise, Office visit, SARS-CoV-2 test positive — 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 professionalMedDRA releases: 2024-11
-
2023-01-17
Report sent to call center — 3 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2023-01-18
- 2023-01-18
-
2023-01-18
Call successfulParticipant prefers to complete VAERS report online
-
2023-01-18
Call successfulParticipant prefers to complete VAERS report online
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-26 | Moderna | Flu |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-10-18 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Sore arm, some bruising at injection site. Mild
Systemic reaction (other): Had a slightly sore throat with some involvement of my ears last night, but that is subsiding
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Strange taste in mouth and change in food taste
Systemic reaction (other): Mild soreness at injection site
Release 7 — day 42, dose 2
Symptoms: Experienced what appeared to be a mild Shingles outbreak on my back and around waist. Have never had Shingles before and have had Shingles vaccines. The rash and itching seem to be subsiding. This actually occurred just prior to second Moderna shot cut off by CDC
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Have had indigestion for a couple days but not sure it is booster-related
Release 10 — day 14, dose 3
Symptoms: Serious bladder infection
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Sore arm at injection site
Release 12 — day 42, dose 5
Symptoms: Feels like a cold or flu. Cough, sore throat, body aches, runny nose, congestion.
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 | Cough | · | · | ✓ |
| SD | Cystitis | · | · | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | · | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Taste disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release