5JW-43286-91884

3 vaccinations 5 coded responses 31 check-ins 5 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 535 / WI
Registered: 2021-03-26

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

2021-03-02
Dose 1 — Moderna
2021-03-26
Registered in v-safe
2021-03-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — day 21, dose 2
MedDRA: Pain in extremity, Tinnitus — Feeling: Good

Free text: I have been hearing a generator type sound in my right ear. My right leg has been very sore in the back from me knee to my buttocks since a few days after first shot. I also have a sore spot on the side of my right leg like I ran into something.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 28, dose 2
MedDRA: Pain in extremity, Tinnitus — Feeling: Good

Free text: Still having some leg pain and having some Tinnitus type issues in my right ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 35, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Still some tinitius type issues with ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Lymphoma, Surgery, Tonsil cancer — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: I have developed cancer in my left tonsil and in at least one lymph node on the left side of my neck. This is the same side of my body that I received my Covid vaccines. · Healthcare visit (other): I had to have surgery and have another surgery to come with possible radiation to follow

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

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-02-04
Call 1 — Left Voicemail
2022-04-29
Survey response — 6 months, dose 3
MedDRA: Lymphoma, Neoplasm malignant, Surgery, Tonsil cancer — 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 · Hospitalization

Free text: Symptoms: 6 weeks after my third booster I developed cancer in my left tonsil and one lymph node in the left side of my neck. Not sure if there is any connection with this and getting the vaccine. · Healthcare visit (other): 2 surgeries to remove cancer

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 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

Hospitalization · 1 call case(s)
2022-05-03
Call 1 — Left Voicemail
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-10-30
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-10-28	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 21, dose 2

2021-04-20

Symptoms: I have been hearing a generator type sound in my right ear. My right leg has been very sore in the back from me knee to my buttocks since a few days after first shot. I also have a sore spot on the side of my right leg like I ran into something.

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Still having some leg pain and having some Tinnitus type issues in my right ear

Release 8 — day 35, dose 2

2021-05-04

Symptoms: Still some tinitius type issues with ears

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: I have developed cancer in my left tonsil and in at least one lymph node on the left side of my neck. This is the same side of my body that I received my Covid vaccines.

Healthcare visit (other): I had to have surgery and have another surgery to come with possible radiation to follow

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: 6 weeks after my third booster I developed cancer in my left tonsil and one lymph node in the left side of my neck. Not sure if there is any connection with this and getting the vaccine.

Healthcare visit (other): 2 surgeries to remove cancer

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	Neoplasm malignant	·	·	✓
HCVO	Surgery	·	·	✓
SD	Lymphoma	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Tonsil cancer	·	·	✓

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