4VC-18152-62483

2 vaccinations 9 coded responses 21 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 208 / MD
Registered: 2021-01-05

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Very slight fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Slight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Fatigue or tiredness

Free text: Slight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Survey response — day 21, dose 1
MedDRA: Nausea, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Intractable nausea and vomiting Fri 01/22/2021. Came on suddenly. Not sure if related to vaccine or not; occurred 17 days post 1st injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Dose 2 — Moderna
2021-02-02
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain at site of injection much worse with 2nd dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Survey response — day 21, dose 2
MedDRA: Nausea — Feeling: Fair

Free text: Nausea 3 weeks after 2nd dose;this nausea occurred at the same time interval as after the 1st dose.However, so far the nausea is much less.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort, Migraine — Feeling: Fair · Be unable to work

Free text: Migraines, GI upset

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 42, dose 2
MedDRA: Lymphadenitis, Lymphadenopathy, Migraine, Office visit — Feeling: Fair · 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: Symptoms: Lymph nodes swollen and inflamed right side back of my neck. Came on suddenly on Sunday 03/14 AM. I had a migraine headache last week that lasted 3/8 - 3/11; didnt totally resolve until Fri/Sat. 3/12-3/13. · Healthcare visit (other): Im scheduling an appointment with Dr. (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Fatigue, Lymphadenopathy, Office visit — 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: 5,weeks after my 2nd dose I experienced fatigue and lymphadenopathy bilaterally posterior cervical chain · Healthcare visit (other): Visit to my primary care MD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
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)
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-07
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Very slight fatigue

2021-01-08

Systemic reaction (other): Slight

2021-01-09

Systemic reaction (other): Slight

Release 2 — day 21, dose 1

2021-01-26

Symptoms: Intractable nausea and vomiting Fri 01/22/2021. Came on suddenly. Not sure if related to vaccine or not; occurred 17 days post 1st injection

Release 3 — day 0, dose 2

2021-02-02

Systemic reaction (other): Pain at site of injection much worse with 2nd dose

Release 4 — day 21, dose 2

2021-02-23

Symptoms: Nausea 3 weeks after 2nd dose;this nausea occurred at the same time interval as after the 1st dose.However, so far the nausea is much less.

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Migraines, GI upset

Release 5 — day 42, dose 2

2021-03-16

Symptoms: Lymph nodes swollen and inflamed right side back of my neck. Came on suddenly on Sunday 03/14 AM. I had a migraine headache last week that lasted 3/8 - 3/11; didnt totally resolve until Fri/Sat. 3/12-3/13.

Healthcare visit (other): Im scheduling an appointment with Dr. (b)(6)

redacted (b)(6)

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: 5,weeks after my 2nd dose I experienced fatigue and lymphadenopathy bilaterally posterior cervical chain

Healthcare visit (other): Visit to my primary care MD

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	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Lymphadenitis	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Unevaluable event	○	○	○

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