5AC-29847-86175

2 vaccinations 8 coded responses 27 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 875 / NM
Registered: 2020-12-31

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Flushing, Pyrexia, Self-medication — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Yesterday after checkin, had transient flushing, sense of feverishness, resolved with ibuprofen

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: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Fatigue or tiredness

Free text: I suspect fatigue is related to ongoing inflammatory bowel disease, without relationship to COVID vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-01-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Survey response — day 0, dose 2
MedDRA: Analgesic drug level, Cold sweat, Feeling abnormal — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Free text: brain fog, clammy after acetaminophen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Disturbance in attention — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: some difficulty in concentration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Most sx actually yesterday late in day after I checked in with you, most somewhat improved today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Survey response — day 7, dose 2
MedDRA: Crohn's disease, Pre-existing disease — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness

Free text: difficult to distinguish symptoms from those of Crohns disease, which I have

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Survey response — day 21, dose 2
MedDRA: Facial pain, Fatigue — Feeling: Fair

Free text: Right facial (ophthalmic) trigeminal neuralgia like pain (onset ? about the time of dental procedure/crown placement tooth #3 implant), with fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Dyspnoea — 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: Shortness of breath

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
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)
2021-08-10
Call successful
Participant prefers to complete VAERS report online
2022-01-29
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-29	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Yesterday after checkin, had transient flushing, sense of feverishness, resolved with ibuprofen

2021-01-05

Systemic reaction (other): I suspect fatigue is related to ongoing inflammatory bowel disease, without relationship to COVID vaccine

Release 3 — day 0, dose 2

2021-01-29

Systemic reaction (other): brain fog, clammy after acetaminophen

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): some difficulty in concentration

2021-01-31

Systemic reaction (other): Most sx actually yesterday late in day after I checked in with you, most somewhat improved today

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): difficult to distinguish symptoms from those of Crohns disease, which I have

Release 4 — day 21, dose 2

2021-02-19

Symptoms: Right facial (ophthalmic) trigeminal neuralgia like pain (onset ? about the time of dental procedure/crown placement tooth #3 implant), with fatigue

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Shortness of breath

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	Dyspnoea	✓	·	✓
SD	Facial pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SRO	Adverse reaction	✓	·	✓
SRO	Analgesic drug level	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Crohn's disease	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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