34S-35379-03133

4 vaccinations 7 coded responses 45 check-ins 7 free-text entries 6 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 344 / FL
Registered: 2021-02-15

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
Registered in v-safe
2021-02-15
Dose 1 — Moderna
2021-02-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 1
MedDRA: Hospitalisation — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I have been in the hospital since Friday and Im just now being discharged.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Dose 2 — Moderna
2021-03-15
Health check-in — day 0, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Nausea

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

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Survey response — day 14, dose 2
MedDRA: Hypertension — Feeling: Fair

Free text: Yes high blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-14
Survey response — 3 months, dose 2
MedDRA: Cough, Headache, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Headache sore throat cough congestion fever aching all over · Healthcare visit (other): Requested prescription it should be here shortly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-09-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Nausea

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-16
Dose 4 — Moderna
2022-04-19
Survey response — days 1–6 daily, dose 4
MedDRA: Hospitalisation, Platelet count decreased — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Been in the hospital since April 16, 2022 about 12 hours after getting the shot. Platelets are at 17

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-04-20
Survey response — days 1–6 daily, dose 4
MedDRA: Platelet count decreased — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Been here since I got the shot. Platelets dropped to 17 and having IVG infusions

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-04-20
Call 1 — Left Voicemail
2022-04-20
Call successful
Participant prefers to complete VAERS report online
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Hospitalization

Adult check-in
2022-04-21
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-04-21
Call 1 — Could Not Reach Participant
2022-04-22
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Headache

Free text: Home from the hospital

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Callback requested for
01:00PM ET
2022-04-23
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-27
Call 2 — Left Voicemail
2022-04-30
Survey response — day 14, dose 4
MedDRA: Hospitalisation — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Back in the hospital 3days after getting discharged.

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-05-03
Call 1 — Left Voicemail
2022-05-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-16
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna
3	2021-10-29	Moderna	No
4	2022-04-16	Moderna	No

Call center

6 call center cases

3 successful · 3 unsuccessful

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-08

Symptoms: I have been in the hospital since Friday and Im just now being discharged.

Release 6 — day 14, dose 2

2021-03-29

Symptoms: Yes high blood pressure

Release 9 — 3 months, dose 2

2021-06-14

Symptoms: Headache sore throat cough congestion fever aching all over

Healthcare visit (other): Requested prescription it should be here shortly

Release 11 — days 1–6 daily, dose 4

2022-04-19

Systemic reaction (other): Been in the hospital since April 16, 2022 about 12 hours after getting the shot. Platelets are at 17

2022-04-20

Healthcare visit (other): Been here since I got the shot. Platelets dropped to 17 and having IVG infusions

2022-04-22

Systemic reaction (other): Home from the hospital

Release 11 — day 14, dose 4

2022-04-30

Symptoms: Back in the hospital 3days after getting discharged.

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	Platelet count decreased	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Hospitalisation	·	·	✓
SRO	Platelet count decreased	·	·	✓
SRO	Unevaluable event	·	·	✓

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