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585-31644-08158

5 vaccinations 10 coded responses 40 check-ins 9 free-text entries 4 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
993 / WA
Registered
2021-01-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-20
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-02-17
    Dose 2 — Moderna
  4. 2021-02-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-02-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness
    Adult check-in
  7. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  8. 2021-02-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site bruising, Injection site discolouration, Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Site: Redness, Itching
    Free text: The itchy spot on my arm is a small raised Bob about 2 inches below the bruise from the injection site. It is not Pasfield but it is a red small box that itches sort of like a mosquito bite. I still have some discoloration in an oval shape around the injection site but it is getting better. I have a small bruise where the needle penetrated the arm aro
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  10. 2021-02-24
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  11. 2021-03-03
    Survey response — day 14, dose 2
    MedDRA: Acne, Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling — Feeling: Good
    Free text: I still have a red raised pimple like spot at the injection site that is itchy sort of like a mosquito bite.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-12
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-19
    Survey response — day 28, dose 2
    MedDRA: Injection site pruritus — Feeling: Good
    Free text: My arm continues to itch at the vax site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-24
    Survey response — day 35, dose 2
    MedDRA: Injection site mass, Injection site pruritus — Feeling: Good
    Free text: I have a raised pimple-like bump at the vaccination site that IIve reported on previous reports. It continues to itch.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-31
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-19
    Survey response — 3 months, dose 2
    MedDRA: Headache — Feeling: Good
    Free text: Slight headache that persists above and behind my left ear. Not debilitating or even painful, but noticeable,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-08-18
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-10-22
    Dose 3 — Moderna
  19. 2021-10-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Fatigue, Injection site pain, Pain, Pyrexia — Feeling: Good
    Free text: I got the shot Friday, 10/22. Saturday 10/23 I had soreness at the injection point and body aches and felt feverish in the afternoon along with fatigue. Today, 2 days post vaccination I am feeling no side effects.
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-10-25
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  21. 2021-10-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  22. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  23. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Joint pains
    Adult check-in
  24. 2021-10-29
    Health check-in — day 7, dose 3
    Feeling: Good · Joint pains
    Adult check-in
  25. 2021-11-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  26. 2021-11-12
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  27. 2021-11-19
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  28. 2021-11-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  29. 2021-12-03
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-01-21
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-03-31
    Dose 4 — Pfizer-BioNTech
  32. 2022-04-14
    Survey response — day 14, dose 4
    MedDRA: Meniere's disease, Vertigo — 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, Emergency room or emergency department visit
    Free text: Vertigo. Spinning episode on 2/16/. Diagnosed in early April with Menier's Disease, left inner ear.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-04-14
    Report sent to call center — day 14, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
  34. 2022-04-20
  35. 2022-04-21
    Survey response — day 21, dose 4
    MedDRA: Balance disorder, Hypoacusis, Meniere's disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Continue to have balance and hearing issues associated with recently diagnosed Ménière's disease.
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-04-21
    Report sent to call center — day 21, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  37. 2022-04-22
    Call successful
    Does not wish to fill out VAERS report
  38. 2022-04-22
    Call successful
    Does not wish to fill out VAERS report
  39. 2022-04-29
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-05-05
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-05-14
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  42. 2022-07-01
    Survey response — 3 months, dose 4
    MedDRA: Dizziness, Meniere's disease, Office visit, Tinnitus, Vertigo, Vomiting — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Meniere's Disease vertigo episode yesterday. Dizziness, vomiting, tinnitus. 5th episode since February. Diagnosed by ENT physician and Audiologist in April. First onset of symptoms Mid-February of 2022.
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-07-01
    Report sent to call center — 3 months, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  44. 2022-07-07
  45. 2022-07-12
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  46. 2022-09-07
    Dose 5 — Moderna
  47. 2022-09-14
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  48. 2022-09-21
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  49. 2022-09-28
    Health check-in — day 21, dose 5
    Feeling: Good
    Adult check-in
  50. 2022-10-06
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  51. 2022-10-12
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  52. 2022-10-19
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  53. 2022-12-07
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  54. 2023-03-08
    Survey response — 6 months, dose 5
    MedDRA: Squamous cell carcinoma of skin — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  55. 2023-03-08
    Report sent to call center — 6 months, dose 5
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  56. 2023-03-09

Vaccinations

DoseDateManufacturerCo-administered
12021-01-20Moderna
22021-02-17Moderna
32021-10-22Moderna No
42022-03-31Pfizer-BioNTech No
52022-09-07Moderna No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): The itchy spot on my arm is a small raised Bob about 2 inches below the bruise from the injection site. It is not Pasfield but it is a red small box that itches sort of like a mosquito bite. I still have some discoloration in an oval shape around the injection site but it is getting better. I have a small bruise where the needle penetrated the arm aro

Release 4 — day 14, dose 2

2021-03-03

Symptoms: I still have a red raised pimple like spot at the injection site that is itchy sort of like a mosquito bite.

Release 5 — day 28, dose 2

2021-03-19

Symptoms: My arm continues to itch at the vax site

Release 6 — day 35, dose 2

2021-03-24

Symptoms: I have a raised pimple-like bump at the vaccination site that IIve reported on previous reports. It continues to itch.

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Slight headache that persists above and behind my left ear. Not debilitating or even painful, but noticeable,

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): I got the shot Friday, 10/22. Saturday 10/23 I had soreness at the injection point and body aches and felt feverish in the afternoon along with fatigue. Today, 2 days post vaccination I am feeling no side effects.

Release 11 — day 14, dose 4

2022-04-14

Symptoms: Vertigo. Spinning episode on 2/16/. Diagnosed in early April with Menier's Disease, left inner ear.

Release 11 — day 21, dose 4

2022-04-21

Symptoms: Continue to have balance and hearing issues associated with recently diagnosed Ménière's disease.

Release 12 — 3 months, dose 4

2022-07-01

Symptoms: Meniere's Disease vertigo episode yesterday. Dizziness, vomiting, tinnitus. 5th episode since February. Diagnosed by ENT physician and Audiologist in April. First onset of symptoms Mid-February of 2022.

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
SDAcne ✓ ✓ ✓
SDBalance disorder · · ✓
SDDizziness · · ✓
SDHeadache ✓ ✓ ✓
SDHypoacusis · · ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site mass ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site reaction ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDMeniere's disease · · ✓
SDOffice visit · · ✓
SDSquamous cell carcinoma of skin · · ✓
SDTinnitus · · ✓
SDVertigo · · ✓
SDVomiting · · ✓
SROFatigue · · ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site discolouration ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pain · · ✓
SROInjection site pruritus ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROPain · · ✓
SROPyrexia · · ✓

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

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