4Z4-39329-70742

2 vaccinations 12 coded responses 19 check-ins 12 free-text entries 2 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 775 / TX
Registered: 2021-04-09

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Moderna
2021-04-09
Survey response — day 0, dose 1
MedDRA: Pain in extremity, Skin warm — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Arm is sore and warm to touch ,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Skin warm — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Arm still warm to touch

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

Free text: Arm sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling, Itching · Chills, Muscle or body aches

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain, Swelling, Itching

Free text: Arm still sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body aches

Free text: Arm sore (slight burning sensation near area)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain, Swelling, Itching

Free text: symptoms reduced (arm sore)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-05
Dose 2 — Moderna
2021-05-14
Survey response — day 7, dose 2
MedDRA: Hypoaesthesia, Pain in extremity — Feeling: Good · Site: Pain

Free text: Weird pain on right arm (I dont know how to describe slight discomfort/numbness)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 14, dose 2
MedDRA: Blister, Erythema, Injection site erythema, Skin warm — Feeling: Good

Free text: My left foot has blisters ,scaly, warm to touch, and red

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 21, dose 2
MedDRA: Middle ear effusion — Feeling: Good

Free text: A lot of Clear fluid on my right ear (crusted when dry)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — day 28, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Otorrhoea, Skin discolouration, Wound secretion — Feeling: Good

Free text: Ears ooze (nasty painful crater wound on face with pus) lower right nymph node swollen and sore . Left foot has crazy leopard circles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 35, dose 2
MedDRA: Deafness unilateral, Drainage, Staphylococcal infection, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear drainage & crusted (cant hear on right ear), I hear ringing 24-7 and staph infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-22
Call successful
Does not wish to fill out VAERS report
2021-08-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Survey response — 6 months, dose 2
MedDRA: Ear infection fungal, Office visit, Skin exfoliation — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ear fungi (flakes) · Healthcare visit (other): Reg dr visit

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-04
Call successful
Participant prefers to complete VAERS report online
2022-05-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-05	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 0, dose 1

2021-04-09

Systemic reaction (other): Arm is sore and warm to touch ,

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Arm still warm to touch

2021-04-11

Systemic reaction (other): Arm sore

2021-04-13

Systemic reaction (other): Arm still sore

2021-04-14

Systemic reaction (other): Arm sore (slight burning sensation near area)

2021-04-15

Systemic reaction (other): symptoms reduced (arm sore)

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Weird pain on right arm (I dont know how to describe slight discomfort/numbness)

Release 8 — day 14, dose 2

2021-05-19

Symptoms: My left foot has blisters ,scaly, warm to touch, and red

Release 8 — day 21, dose 2

2021-05-26

Symptoms: A lot of Clear fluid on my right ear (crusted when dry)

Release 8 — day 28, dose 2

2021-06-02

Symptoms: Ears ooze (nasty painful crater wound on face with pus) lower right nymph node swollen and sore . Left foot has crazy leopard circles

Release 9 — day 35, dose 2

2021-06-11

Symptoms: Ear drainage & crusted (cant hear on right ear), I hear ringing 24-7 and staph infection.

Release 10 — 6 months, dose 2

2021-11-03

Symptoms: Ear fungi (flakes)

Healthcare visit (other): Reg dr 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	Office visit	·	·	✓
SD	Blister	✓	✓	✓
SD	Deafness unilateral	✓	✓	✓
SD	Drainage	✓	✓	✓
SD	Ear infection fungal	·	·	✓
SD	Erythema	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Lymph node pain	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Middle ear effusion	✓	✓	✓
SD	Otorrhoea	✓	✓	✓
SD	Skin discolouration	✓	✓	✓
SD	Skin exfoliation	·	·	✓
SD	Skin warm	✓	✓	✓
SD	Staphylococcal infection	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Wound secretion	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Skin warm	✓	✓	✓

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