3GP-28406-54426

2 vaccinations 13 coded responses 25 check-ins 13 free-text entries 6 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 144 / NY
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia, Migraine — Feeling: Fair

Free text: Insomnia and chronic migraine almost certainly unrelated to the COVID vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia, Migraine — Feeling: Fair · Headache

Free text: Chronic migraine due at least in part to insomnia almost certainly NOT an effect of the COVID-19 vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia, Loss of personal independence in daily activities, Migraine, Sensitivity to weather change — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: Insomnia and chronic migraine severe enough to spend the day in bed. Unusually but certainly not atypically severe and unlikely to have been related to the COVID-19 vaccination. More likely triggered by the sunny day.

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

Free text: Chronic migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Migraine, Pre-existing disease — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Chronic migraine almost certainly unrelated to COVID-19 vaccine.

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

Free text: Continued chronic migraine almost certainly unrelated to COVID-19 vaccination. Spent day in bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 7, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Survey response — day 14, dose 1
MedDRA: Migraine — Feeling: Poor · Be unable to do your normal daily activities

Free text: Chronic migraine; 4 days in bed. This is somewhat abnormally bad for me; 1-2 days per week is more typical.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Survey response — day 0, dose 2
MedDRA: Chest pain, Dyspepsia, Immediate post-injection reaction, Myocardial infarction, Pain in extremity, Stent placement — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Arm pain immediately below the injection site, chest pain, acute indigestion, heart attack 35 minutes after receiving the second dose. 3 Stents inserted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Hospitalisation, Myocardial infarction — Feeling: Fair · Fever · Get care from a doctor or other healthcare professional · Hospitalization

Free text: In hospital recovering from heart attack suffered half an hour after having received 2nd dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · None · Get care from a doctor or other healthcare professional · Hospitalization

Adult check-in
2021-03-07
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · None · Get care from a doctor or other healthcare professional · Hospitalization

Adult check-in
2021-03-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: Migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: Migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-04-09
Survey response — day 35, dose 2
MedDRA: Contusion, Medical counselling, Peripheral swelling — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Unexplained bruising with and without swelling on limbs. · Healthcare visit (other): Cardiac rehab nurse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Back pain, Musculoskeletal chest pain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain lower back rib pain · Healthcare visit (other): Physician physical office visit

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

1 call case(s)
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): Insomnia and chronic migraine almost certainly unrelated to the COVID vaccine

2021-02-07

Systemic reaction (other): Chronic migraine due at least in part to insomnia almost certainly NOT an effect of the COVID-19 vaccine.

2021-02-08

Systemic reaction (other): Insomnia and chronic migraine severe enough to spend the day in bed. Unusually but certainly not atypically severe and unlikely to have been related to the COVID-19 vaccination. More likely triggered by the sunny day.

2021-02-09

Systemic reaction (other): Chronic migraine

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Chronic migraine almost certainly unrelated to COVID-19 vaccine.

2021-02-11

Systemic reaction (other): Continued chronic migraine almost certainly unrelated to COVID-19 vaccination. Spent day in bed.

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Chronic migraine; 4 days in bed. This is somewhat abnormally bad for me; 1-2 days per week is more typical.

Release 5 — day 0, dose 2

2021-03-05

Systemic reaction (other): Arm pain immediately below the injection site, chest pain, acute indigestion, heart attack 35 minutes after receiving the second dose. 3 Stents inserted.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): In hospital recovering from heart attack suffered half an hour after having received 2nd dose.

2021-03-09

Systemic reaction (other): Migraine

2021-03-10

Systemic reaction (other): Migraine

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Unexplained bruising with and without swelling on limbs.

Healthcare visit (other): Cardiac rehab nurse

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Pain lower back rib pain

Healthcare visit (other): Physician physical office visit

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Myocardial infarction	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sensitivity to weather change	✓	✓	✓
SRO	Stent placement	✓	✓	✓

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