3DP-14296-07736

2 vaccinations 12 coded responses 25 check-ins 12 free-text entries 6 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 832 / ID
Registered: 2021-02-18

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

2021-02-17
Dose 1 — Moderna
2021-02-18
Registered in v-safe
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Dyspnoea — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness and shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-17
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Numbness in right hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Muscle or body aches

Free text: Right hand numbness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — day 14, dose 2
MedDRA: Dizziness, Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Worsening dizziness and shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 21, dose 2
MedDRA: Dizziness, Dyspnoea, Fluid retention, Unevaluable event, Weight increased — 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, Emergency room or emergency department visit

Free text: Symptoms: Shortness of breath; dizziness; water retention; weight gain. · Healthcare visit (other): Testing currently.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — day 21, 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)
2021-04-14
Survey response — day 28, dose 2
MedDRA: Cardiac pacemaker insertion — Feeling: Good · 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, Emergency room or emergency department visit, Hospitalization

Free text: Got a pacemaker

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 28, 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)
2021-04-23
Survey response — day 35, dose 2
MedDRA: Cardiac pacemaker insertion — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I had a pacemaker inserted. I reported it yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 35, 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)
2021-04-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — 3 months, dose 2
MedDRA: Asthenia, Back pain, Cardiac pacemaker insertion, Fluid retention, Office visit, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Pacemaker inserted; water retention; lack of energy; back ache. · Healthcare visit (other): Follow-ups with doctors

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-18
Call successful
Completed over the phone
2021-09-15
Survey response — 6 months, dose 2
MedDRA: Office visit, Skin ulcer — Feeling: Fair · 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: Symptoms: I have 3 sores on my right leg between my knee and ankle that my doctor has prescribed antibiotics for. They are doing better but not well yet and I am well into my 3rd rx · Healthcare visit (other): Follow up with my primary care doctor.

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call successful
Completed over the phone
2022-03-17
Survey response — 12 months, dose 2
MedDRA: Asthenia, Decreased interest, Exercise tolerance decreased, Insomnia, Office visit, Somnolence — 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

Free text: Symptoms: No energy, sleepy all the time, no enthusiasm for anything, no endurance and not sleeping at night very well. · Healthcare visit (other): Office visits - VA and private drs.

MedDRA releases: 2024-11 · check-in free text available
2022-03-17
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-03-18
Call 1 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-17	Moderna

Call center

6 call center cases

5 successful · 1 unsuccessful

VAERS report filed, before or during a call: 6

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): Light headedness

2021-02-20

Systemic reaction (other): Still light headed

2021-02-21

Systemic reaction (other): Dizziness and shortness of breath

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Numbness in right hand

2021-03-21

Systemic reaction (other): Right hand numbness

Release 6 — day 14, dose 2

2021-03-31

Symptoms: Worsening dizziness and shortness of breath.

Release 7 — day 21, dose 2

2021-04-07

Symptoms: Shortness of breath; dizziness; water retention; weight gain.

Healthcare visit (other): Testing currently.

Release 7 — day 28, dose 2

2021-04-14

Symptoms: Got a pacemaker

Release 7 — day 35, dose 2

2021-04-23

Symptoms: I had a pacemaker inserted. I reported it yesterday.

Release 9 — 3 months, dose 2

2021-06-16

Symptoms: Pacemaker inserted; water retention; lack of energy; back ache.

Healthcare visit (other): Follow-ups with doctors

Release 9 — 6 months, dose 2

2021-09-15

Symptoms: I have 3 sores on my right leg between my knee and ankle that my doctor has prescribed antibiotics for. They are doing better but not well yet and I am well into my 3rd rx

Healthcare visit (other): Follow up with my primary care doctor.

Release 11 — 12 months, dose 2

2022-03-17

Symptoms: No energy, sleepy all the time, no enthusiasm for anything, no endurance and not sleeping at night very well.

Healthcare visit (other): Office visits - VA and private drs.

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Cardiac pacemaker insertion	✓	✓	✓
SD	Decreased interest	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Exercise tolerance decreased	·	·	✓
SD	Fluid retention	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Pain	✓	✓	○
SD	Skin ulcer	·	·	✓
SD	Somnolence	·	·	✓
SD	Weight increased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓

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