35W-11230-53200

1 vaccination 6 coded responses 8 check-ins 6 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 272 / NC
Registered: 2021-01-06

Relationship: Self

Timeline

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-16
Survey response — day 7, dose 1
MedDRA: Apathy, Disturbance in attention, Dizziness — Feeling: Poor · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: On the verge of dizziness and difficulty focusing for work or for example writing this. Listen normal appetite. Diminished motivation to get up and do anything.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-21
Survey response — day 14, dose 1
MedDRA: Arthralgia, Dizziness, Headache, Pain, Rash erythematous — Feeling: Poor · Be unable to do your normal daily activities

Free text: Vaccination a week nd half ago resulting in dizziness, difficult mentation eg, administering my clinic, headache, a firey, red, rash over 90% of my upper body and 30% of my lower body, joint pain and muscle ache. Most symptoms now are worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 21, dose 1
MedDRA: Arthralgia, Dizziness, Fatigue, Headache, Mental disorder, Myalgia, Rash, Rash erythematous, Rash papular, Rash pruritic, Skin warm — 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: Dizziness, headache, poor mentation, Worsening joint pain and muscle ache in many locations. Moderate to severe fatigue. Fiery, terribly itchy, red, lumpy rash over 90% of upper body and 30% of lower body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Report sent to call center — day 21, 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)
2021-02-04
Survey response — day 28, dose 1
MedDRA: Arthralgia, Fatigue, Feeling abnormal, Medical counselling, Myalgia, Rash — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: At this moment I am not interested in getting the 2nd shot because of extreme joint and muscle pain, sense of being dazed, fatigue and lack of mental sharpness along with continuing rash. My MD encouraged me to get the 2nd but my symptoms scare me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 35, dose 1
MedDRA: Arthralgia, Dizziness, Fatigue, Libido decreased, Myalgia, Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Serious, worsening joint and muscle pain. Dizzy often. Constantly tired despite what appears to be good 8 hours sleep + 1 hr daily nap. Itchy. Diminished libido. I'm afraid a second shot might make things substantially worse then not having a shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 35, 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)
2021-02-18
Survey response — day 42, dose 1
MedDRA: Arthralgia, Dizziness, Fatigue, Feeling abnormal, Myalgia, Peripheral swelling, Rash — 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, Outpatient clinic or urgent care clinic visit

Free text: Dizzy, pain in joints and muscles, fatigued, swollen phalanges, loss of much mental clarity. At least the rash has diminished although some remains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 42, 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)
2021-06-04
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna

Call center

4 call center cases

3 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-16

Systemic reaction (other): On the verge of dizziness and difficulty focusing for work or for example writing this. Listen normal appetite. Diminished motivation to get up and do anything.

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Vaccination a week nd half ago resulting in dizziness, difficult mentation eg, administering my clinic, headache, a firey, red, rash over 90% of my upper body and 30% of my lower body, joint pain and muscle ache. Most symptoms now are worse.

Release 2 — day 21, dose 1

2021-01-27

Symptoms: Dizziness, headache, poor mentation, Worsening joint pain and muscle ache in many locations. Moderate to severe fatigue. Fiery, terribly itchy, red, lumpy rash over 90% of upper body and 30% of lower body

Release 3 — day 28, dose 1

2021-02-04

Symptoms: At this moment I am not interested in getting the 2nd shot because of extreme joint and muscle pain, sense of being dazed, fatigue and lack of mental sharpness along with continuing rash. My MD encouraged me to get the 2nd but my symptoms scare me. cut off by CDC

Release 4 — day 35, dose 1

2021-02-10

Symptoms: Serious, worsening joint and muscle pain. Dizzy often. Constantly tired despite what appears to be good 8 hours sleep + 1 hr daily nap. Itchy. Diminished libido. I'm afraid a second shot might make things substantially worse then not having a shot

Release 4 — day 42, dose 1

2021-02-18

Symptoms: Dizzy, pain in joints and muscles, fatigued, swollen phalanges, loss of much mental clarity. At least the rash has diminished although some remains

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
SD	Arthralgia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Libido decreased	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Mental disorder	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash papular	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Skin warm	✓	✓	✓
SRO	Apathy	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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