5T2-53475-14968

3 vaccinations 10 coded responses 13 check-ins 10 free-text entries 3 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 302 / GA
Registered: 2021-12-07

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

2021-03-07
Dose 1 — Moderna
2021-04-04
Dose 2 — Moderna
2021-12-07
Registered in v-safe
2021-12-07
Dose 3 — Pfizer-BioNTech
2021-12-07
Survey response — day 0, dose 3
MedDRA: Eczema, Pre-existing disease, Tinnitus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Seems to have caused eczema to flare up. Tinnitus is significantly worse.

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease, Tinnitus, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · 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: Systemic reaction (other): Tinnitus is still much worse. Eczema sea to have been triggered by the injection. · Healthcare visit (other): Have first available appointment tomorrow with doctor.

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — days 1–6 daily, 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 · 1 call case(s)
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Eczema, Tinnitus — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinnitus and eczema

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Call successful
Participant prefers to complete VAERS report online
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Eczema, Tinnitus — Feeling: Good · Site: Pain · Abdominal pain

Free text: Tinnitus and eczema

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Eczema, Tinnitus — Feeling: Good · Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinnitus, eczema

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Eczema, Tinnitus — Feeling: Fair · Headache, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinnitus, eczema

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — day 7, dose 3
MedDRA: Eczema, Tinnitus — Feeling: Good · Muscle or body aches, Abdominal pain

Free text: Tinnitus, eczema

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Survey response — day 14, dose 3
MedDRA: Eczema, Office visit, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Eczema has spread. Saw Dr for this and tinnitus shortly after receiving booster. I have not seen Dr since

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-27
Call successful
Participant prefers to complete VAERS report online
2022-01-11
Survey response — day 35, dose 3
MedDRA: Eczema — Feeling: Fair

Free text: Eczema has continued to spread. I will likely have to consult a doctor about this bit it is difficult with my work schedule.

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-08
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-12-07
Survey response — 12 months, dose 3
MedDRA: COVID-19, Cough, Office visit — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Contracted COVID in June. Experienced COVID rebound. Had severe coughing issues and some other lingering problems for several.months. Was diagnosed with long COVID. I have mostly recovered. · Healthcare visit (other): Treatment and evaluation by specialist

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Report sent to call center — 12 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)
2022-12-08
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-07	Moderna	No
2	2021-04-04	Moderna	No
3	2021-12-07	Pfizer-BioNTech	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 10 — day 0, dose 3

2021-12-07

Systemic reaction (other): Seems to have caused eczema to flare up. Tinnitus is significantly worse.

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): Tinnitus is still much worse. Eczema sea to have been triggered by the injection.

Healthcare visit (other): Have first available appointment tomorrow with doctor.

2021-12-09

Systemic reaction (other): Tinnitus and eczema

2021-12-10

Systemic reaction (other): Tinnitus and eczema

2021-12-12

Systemic reaction (other): Tinnitus, eczema

2021-12-13

Systemic reaction (other): Tinnitus, eczema

Release 10 — day 7, dose 3

2021-12-14

Systemic reaction (other): Tinnitus, eczema

Release 10 — day 14, dose 3

2021-12-24

Symptoms: Eczema has spread. Saw Dr for this and tinnitus shortly after receiving booster. I have not seen Dr since

Release 10 — day 35, dose 3

2022-01-11

Symptoms: Eczema has continued to spread. I will likely have to consult a doctor about this bit it is difficult with my work schedule.

Release 12 — 12 months, dose 3

2022-12-07

Symptoms: Contracted COVID in June. Experienced COVID rebound. Had severe coughing issues and some other lingering problems for several.months. Was diagnosed with long COVID. I have mostly recovered.

Healthcare visit (other): Treatment and evaluation by specialist

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	Office visit	·	·	✓
HCVO	Pre-existing disease	·	·	✓
HCVO	Tinnitus	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Eczema	·	·	✓
SD	Office visit	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Eczema	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Tinnitus	·	·	✓

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