4WK-27392-25976

2 vaccinations 5 coded responses 25 check-ins 5 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 189 / PA
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild symptoms but have been improving

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Free text: I had Covid 4/4/20. Initial symptoms after vaccine were identical to my Covid. ie extreme FATIGUE only ! In 36 hrs after vaccine start to improve quickly!! At 48 hrs after vaccine 95 % of my normal!!!

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

Free text: Very minimal tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Nausea

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

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Atrial fibrillation, Transient ischaemic attack — Feeling: Good · 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: Had new episode of new A-Fibrillation and Transient Ischemic Attack

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
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)
2022-02-02
Survey response — 12 months, dose 2
MedDRA: Atrial fibrillation, Cerebrovascular accident — 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 · Emergency room or emergency department visit, Hospitalization

Free text: CVA secondary to sudden transition from sinus heart rhythm to atrial fibrillation

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-03
Call 1 — Requested Callback
2022-02-03
Callback requested for
05:00PM ET
2022-02-03
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-02-02	Moderna

Call center

3 call center cases

2 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-30

Systemic reaction (other): Mild symptoms but have been improving

2020-12-31

Systemic reaction (other): I had Covid 4/4/20. Initial symptoms after vaccine were identical to my Covid. ie extreme FATIGUE only ! In 36 hrs after vaccine start to improve quickly!! At 48 hrs after vaccine 95 % of my normal!!!

2021-01-01

Systemic reaction (other): Very minimal tiredness

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Had new episode of new A-Fibrillation and Transient Ischemic Attack

Release 11 — 12 months, dose 2

2022-02-02

Symptoms: CVA secondary to sudden transition from sinus heart rhythm to atrial fibrillation

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	Cerebrovascular accident	·	·	✓
SD	Transient ischaemic attack	✓	·	✓
SRO	Adverse reaction	○	○	○
SRO	Fatigue	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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