42D-12923-74207

2 vaccinations 5 coded responses 24 check-ins 5 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 208 / MD
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Atrial fibrillation, Dyspnoea, Lethargy, Myalgia, Pain, Pyrexia — Feeling: Poor · 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: Fever, body and muscle aches, shortness of breath, lethargy, atrial fibrillation...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — day 14, 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)
2021-04-26
Survey response — day 21, dose 2
MedDRA: Atrial fibrillation, Hospitalisation, Myositis, Pericarditis, Pleurisy — Feeling: Poor · 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: Acute onset viral or autoimmune (ie post -vaccination) pleuritis, pericarditis and myositis causing atrial fibrillation and requiring hospitalization and a whole battery of tests. Trying not to be a poster child for vaccine side effects , but...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
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)
2021-05-03
Survey response — day 28, dose 2
MedDRA: Atrial fibrillation, Dyspnoea, Fatigue — 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: Atrial fibrillation, tired all the time, winded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
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)
2021-05-10
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Survey response — day 42, dose 2
MedDRA: Atrial fibrillation, Dyspnoea, Headache, Pericarditis — 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: Atrial fibrillation, shortness of breath, headaches, pericarditis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Report sent to call center — day 42, 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)
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Survey response — 6 months, dose 2
MedDRA: COVID-19, Respiratory tract congestion — Feeling: Good · 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 consultation, Outpatient clinic or urgent care clinic visit

Free text: Congested due to Covid

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-07
Call 1 — Left Voicemail
2021-10-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2022-04-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna

Call center

5 call center cases

5 successful

VAERS report filed, before or during a call: 4

See the call center timeline

Free text

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Fever, body and muscle aches, shortness of breath, lethargy, atrial fibrillation...

Release 8 — day 21, dose 2

2021-04-26

Symptoms: Acute onset viral or autoimmune (ie post -vaccination) pleuritis, pericarditis and myositis causing atrial fibrillation and requiring hospitalization and a whole battery of tests. Trying not to be a poster child for vaccine side effects , but...

Release 8 — day 28, dose 2

2021-05-03

Symptoms: Atrial fibrillation, tired all the time, winded

Release 8 — day 42, dose 2

2021-05-17

Symptoms: Atrial fibrillation, shortness of breath, headaches, pericarditis

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Congested due to Covid

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	Atrial fibrillation	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Myositis	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pericarditis	✓	✓	✓
SD	Pleurisy	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓

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