33K-25433-94688
1 vaccination
6 coded responses
8 check-ins
6 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 302 / GA
- Registered
- 2021-08-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-08-02
Dose 1 — Moderna
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2021-08-04
Registered in v-safe
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2021-08-04
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Dizziness, flightiness, spacey headedMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-05
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Still feeling light headed but somewhat better.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-06
Survey response — days 1–6 daily, dose 1MedDRA: Brain fog, Dizziness, Headache — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Head is still flighty, dizzy feeling. More of a light headache today.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-07
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-08-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-08-10
Survey response — day 7, dose 1MedDRA: Feeling abnormal — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolFree text: Felt really bad todayMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-16
Survey response — day 14, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Poor · 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 consultationFree text: I tested positive for Covid on August 10th.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-16
Report sent to call center — day 14, dose 1Be 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)
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2021-12-03
Call successfulParticipant prefers to complete VAERS report online
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2022-01-31
Survey response — 6 months, dose 1MedDRA: Erectile dysfunction, Immunisation reaction, Malaise, Office visit, Parosmia, Somnolence, Taste disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I had to wait several months before I got my second shot. I got Covid arm and was very very sick days 8-10. Started feeling much, much better after this. Smell and taste still are not correct, have to sleep more. Developed impotency almost overnight · Healthcare visit (other): Office visits with my ENT, and my PCP.MedDRA releases: 2024-11 · check-in free text available
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2022-01-31
Report sent to call center — 6 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-02 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness, flightiness, spacey headed
Systemic reaction (other): Still feeling light headed but somewhat better.
Systemic reaction (other): Head is still flighty, dizzy feeling. More of a light headache today.
Release 9 — day 7, dose 1
Systemic reaction (other): Felt really bad today
Release 9 — day 14, dose 1
Symptoms: I tested positive for Covid on August 10th.
Release 11 — 6 months, dose 1
Symptoms: I had to wait several months before I got my second shot. I got Covid arm and was very very sick days 8-10. Started feeling much, much better after this. Smell and taste still are not correct, have to sleep more. Developed impotency almost overnight cut off by CDC
Healthcare visit (other): Office visits with my ENT, and my PCP.
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 | Erectile dysfunction | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Parosmia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Taste disorder | · | · | ✓ |
| SRO | Brain fog | ✓ | · | ✓ |
| SRO | Dizziness | ✓ | · | ✓ |
| SRO | Feeling abnormal | ✓ | · | ✓ |
| SRO | Headache | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release