5SF-13376-11756

4 vaccinations 7 coded responses 24 check-ins 6 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 410 / KY
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

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

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

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

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Depression, Heart rate increased — Feeling: Poor · 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: Medication related changes to blood pressure and heart rate. Increased depression.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Survey response — day 28, dose 2
MedDRA: Cough, Headache — Feeling: Fair

Free text: Persistent cough and headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Respiratory disorder, Sinus disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Allergy related upper respiratorysinuses, eyes primarily. Also am having to have a root canal, tooth no. 3.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Clostridium difficile infection, Cough, Diarrhoea, Vomiting — 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

Free text: vomiting, diarrhea, persistent cough, and was diagnosed with c. diff.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
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)
2021-08-27
Call 1 — Could Not Reach Participant
2021-08-27
Call 1 — Could Not Reach Participant
2021-08-27
Call 1 — Could Not Reach Participant
2021-09-16
Call successful
Reported to VAERS during previous contact from GDIT
2021-09-16
Call successful
Reported to VAERS during previous contact from GDIT
2021-09-16
Call successful
Reported to VAERS during previous contact from GDIT
2021-11-29
Dose 3 — Moderna
2022-03-02
Survey response — 12 months, dose 2
MedDRA: Inflammation — Feeling: Good

Free text: General inflammatory symptoms, probably relative to diet and/or medication change.

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Survey response — 6 months, dose 3
MedDRA: Ageusia, Cough, Headache, Listless, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, headaches, listlessness, loss of taste, sore throat.

MedDRA releases: 2024-11 · check-in free text available
2022-07-12
Dose 4 — Moderna
2022-10-11
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-01-10
Survey response — 6 months, dose 4
MedDRA: Cough, Diarrhoea, Influenza like illness, Nausea, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-11-29	Moderna	No
4	2022-07-12	Moderna	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Medication related changes to blood pressure and heart rate. Increased depression.

Release 6 — day 28, dose 2

2021-03-29

Symptoms: Persistent cough and headaches.

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Allergy related upper respiratorysinuses, eyes primarily. Also am having to have a root canal, tooth no. 3.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: vomiting, diarrhea, persistent cough, and was diagnosed with c. diff.

Release 11 — 12 months, dose 2

2022-03-02

Symptoms: General inflammatory symptoms, probably relative to diet and/or medication change.

Release 11 — 6 months, dose 3

2022-05-30

Symptoms: Cough, headaches, listlessness, loss of taste, sore throat.

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	Ageusia	·	·	✓
SD	Blood pressure increased	✓	✓	✓
SD	Clostridium difficile infection	✓	·	✓
SD	Cough	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Diarrhoea	✓	·	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Inflammation	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Listless	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus disorder	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Vomiting	✓	·	✓

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