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4HH-23176-48422

3 vaccinations 9 coded responses 40 check-ins 8 free-text entries 3 call cases
Sex
Male
Age at first dose
36-40
ZIP prefix
376 / TN
Registered
2021-03-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-02
    Registered in v-safe
  2. 2021-03-02
    Dose 1 — Moderna
  3. 2021-03-02
    Survey response — day 0, dose 1
    MedDRA: Cold sweat, Dizziness, Immediate post-injection reaction — Feeling: Good · Site: Pain · Chills, Nausea
    Free text: 30 min after had dizziness and clammy but short lived
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-03-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches
    Adult check-in
  6. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  7. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  10. 2021-03-09
    Survey response — day 7, dose 1
    MedDRA: Arthralgia, Musculoskeletal pain, Neck pain, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Joint pains · 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: Systemic reaction (other): Pain in my left shoulder, neck, and back shoulder blade area on same side as injection · Healthcare visit (other): Going to see pcp
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-09
    Report sent to call center — day 7, 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)
  12. 2021-03-16
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-03-23
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-03-30
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-04-01
    Dose 2 — Moderna
  16. 2021-04-01
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  17. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  18. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  19. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches
    Adult check-in
  20. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  21. 2021-04-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling · Muscle or body aches
    Adult check-in
  22. 2021-04-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  23. 2021-04-08
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  24. 2021-04-15
    Survey response — day 14, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Not sure if related but suddenly have developed lower right abdomen dull pain. Nurse thinks it could be failing appendix.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-04-22
    Survey response — day 21, dose 2
    MedDRA: Fatigue, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activities
    Free text: The past week or so I have been more tired feeling the normal and have noticed a little bit of increased muscle weakness or fatigue sort of like I felt after having second shot. It's like it went away for a while and now has sort of resurfaced some.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-04-29
    Survey response — day 28, dose 2
    MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Still having increased fatigue and headaches since 2nd shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-05-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-05-13
    Survey response — day 42, dose 2
    MedDRA: Headache, Muscle fatigue — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Seem to have more frequent headaches, and more body/muscle fatigue.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  29. 2021-07-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2021-09-30
    Survey response — 6 months, dose 2
    MedDRA: Arthritis, Inflammation, Office visit — Feeling: Good · 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: Unexplained inflammation of hips and back, and joints in general. No arthritis indicators, drs still trying to find reason. · Healthcare visit (other): Orthopedic
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-09-30
    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
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  32. 2021-10-01
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  33. 2022-04-01
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in
  34. 2022-11-13
    Dose 3 — Pfizer-BioNTech
  35. 2022-11-14
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  36. 2022-11-15
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  37. 2022-11-16
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  38. 2022-11-17
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Diarrhea
    Adult check-in
  39. 2022-11-18
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  40. 2022-11-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  41. 2022-11-20
    Health check-in — day 7, dose 3
    Feeling: Good · Headache
    Adult check-in
  42. 2022-11-27
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-12-04
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  44. 2022-12-11
    Survey response — day 28, dose 3
    MedDRA: Headache — Feeling: Good
    Free text: Daily headache
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-12-18
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  46. 2022-12-25
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  47. 2023-02-12
    Survey response — 3 months, dose 3
    MedDRA: Dyspnoea, Palpitations, Respiration abnormal — Feeling: Good · 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
    MedDRA releases: 2024-11
  48. 2023-02-12
    Report sent to call center — 3 months, dose 3
    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 · 1 call case(s)
  49. 2023-02-14
  50. 2023-02-14
  51. 2023-02-14
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-02Moderna
22021-04-01Moderna
32022-11-13Pfizer-BioNTech No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-03-02

Systemic reaction (other): 30 min after had dizziness and clammy but short lived

Release 5 — day 7, dose 1

2021-03-09

Systemic reaction (other): Pain in my left shoulder, neck, and back shoulder blade area on same side as injection
Healthcare visit (other): Going to see pcp

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Not sure if related but suddenly have developed lower right abdomen dull pain. Nurse thinks it could be failing appendix.

Release 7 — day 21, dose 2

2021-04-22

Symptoms: The past week or so I have been more tired feeling the normal and have noticed a little bit of increased muscle weakness or fatigue sort of like I felt after having second shot. It's like it went away for a while and now has sort of resurfaced some. cut off by CDC

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Still having increased fatigue and headaches since 2nd shot.

Release 8 — day 42, dose 2

2021-05-13

Symptoms: Seem to have more frequent headaches, and more body/muscle fatigue.

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Unexplained inflammation of hips and back, and joints in general. No arthritis indicators, drs still trying to find reason.
Healthcare visit (other): Orthopedic

Release 12 — day 28, dose 3

2022-12-11

Symptoms: Daily headache

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
HCVOUnevaluable event ✓ ✓ ✓
SDArthritis · · ✓
SDDyspnoea · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInflammation · · ✓
SDMuscle fatigue ✓ ✓ ✓
SDMuscular weakness ✓ ✓ ✓
SDOffice visit · · ✓
SDPalpitations · · ✓
SDRespiration abnormal · · ✓
SDUnevaluable event ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROCold sweat ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROMusculoskeletal pain ✓ ✓ ✓
SRONeck pain ✓ ✓ ✓

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