57H-14194-44284

5 vaccinations 14 coded responses 47 check-ins 14 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 672 / KS
Registered: 2021-02-24

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

2021-02-19
Dose 1 — Moderna
2021-02-24
Registered in v-safe
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-02-25
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — day 7, dose 1
MedDRA: Blister, Peripheral swelling, Purpura — Feeling: Fair · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Swollen hands with purple rash and blistering

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Good · Site: Pain, Swelling · Be unable to do your normal daily activities

Free text: Swollen hands mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fever · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-19
Survey response — 6 months, dose 2
MedDRA: Fatigue, Gastrointestinal disorder, SARS-CoV-2 antibody test negative — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, intestinal issues · Healthcare visit (other): I got a covid rapid antibody test and it was negative

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Call successful
Participant prefers to complete VAERS report online
2021-10-29
Dose 3 — Moderna
2021-11-17
Survey response — day 14, dose 3
MedDRA: Amnesia, Brain fog, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Loss of working memory (brain fog), headache, and chronic exhaustion

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 21, dose 3
MedDRA: Brain fog, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Exhaustion and brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 28, dose 3
MedDRA: Brain fog, Headache, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, brain fog, lethargy

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-12
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Dizziness, Lethargy, Sinus disorder, Tinnitus — Feeling: Poor · 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: Tinnitus, sinus issues, lethargy, dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 months, dose 3
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)
2022-02-01
Call successful
Participant prefers to complete VAERS report online
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Fungal infection, Genital infection — 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: A bad fungal infection in my privates

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Report sent to call center — 6 months, dose 3
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)
2022-05-03
Call 1 — Left Voicemail
2022-06-10
Dose 4 — Moderna
2022-06-21
Health check-in — day 7, dose 4
Feeling: Good · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-06-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-08
Survey response — day 28, dose 4
MedDRA: Arthralgia, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lethargy and joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Survey response — day 35, dose 4
MedDRA: Headache, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache and still experiencing lethargy

MedDRA releases: 2024-11 · check-in free text available
2022-07-22
Survey response — day 42, dose 4
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Spontaneous pain in lower left leg ankle and knee for no apparent reason

MedDRA releases: 2024-11 · check-in free text available
2022-09-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-17
Dose 5 — Pfizer-BioNTech
2022-09-17
Health check-in — day 0, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2022-09-24
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-01
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-08
Survey response — day 21, dose 5
MedDRA: Lethargy — Feeling: Good · Be unable to do your normal daily activities

Free text: Lethargy

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-29
Survey response — day 42, dose 5
MedDRA: Diarrhoea, Headache, Lethargy, Malaise — Feeling: Good

Free text: I had a sick headache, diarrhea, and lethargy for 3 days this week. I am feeling better today but remain lethargic.

MedDRA releases: 2024-11 · check-in free text available
2022-12-17
Survey response — 3 months, dose 5
MedDRA: Lethargy, Pulmonary congestion, Sinus 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

Free text: Congestion in sinuses of moderate nature and congestion of lungs of a mild nature. Extra lethargic the last week.

MedDRA releases: 2024-11 · check-in free text available
2022-12-17
Report sent to call center — 3 months, dose 5
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 · 1 call case(s)
2022-12-19
Call 2 — Left Voicemail
2022-12-19
Call 1 — Left Voicemail
2023-03-18
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-10-29	Moderna	No
4	2022-06-10	Moderna	No
5	2022-09-17	Pfizer-BioNTech	No

Call center

5 call center cases

3 successful · 2 unsuccessful

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-27

Systemic reaction (other): Swollen hands with purple rash and blistering

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Swollen hands mild

Release 9 — 6 months, dose 2

2021-09-19

Symptoms: Fatigue, intestinal issues

Healthcare visit (other): I got a covid rapid antibody test and it was negative

Release 10 — day 14, dose 3

2021-11-17

Symptoms: Loss of working memory (brain fog), headache, and chronic exhaustion

Release 10 — day 21, dose 3

2021-11-20

Symptoms: Exhaustion and brain fog

Release 10 — day 28, dose 3

2021-11-27

Symptoms: Headache, brain fog, lethargy

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Tinnitus, sinus issues, lethargy, dizziness

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: A bad fungal infection in my privates

Release 12 — day 28, dose 4

2022-07-08

Symptoms: Lethargy and joint pain

Release 12 — day 35, dose 4

2022-07-15

Symptoms: Headache and still experiencing lethargy

Release 12 — day 42, dose 4

2022-07-22

Symptoms: Spontaneous pain in lower left leg ankle and knee for no apparent reason

Release 12 — day 21, dose 5

2022-10-08

Symptoms: Lethargy

Release 12 — day 42, dose 5

2022-10-29

Symptoms: I had a sick headache, diarrhea, and lethargy for 3 days this week. I am feeling better today but remain lethargic.

Release 12 — 3 months, dose 5

2022-12-17

Symptoms: Congestion in sinuses of moderate nature and congestion of lungs of a mild nature. Extra lethargic the last week.

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	SARS-CoV-2 antibody test negative	·	·	✓
SD	Amnesia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Brain fog	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Fungal infection	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Genital infection	·	·	✓
SD	Headache	·	·	✓
SD	Lethargy	·	·	✓
SD	Malaise	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pulmonary congestion	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Blister	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Purpura	✓	✓	✓

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