5XD-24618-87506

4 vaccinations 12 coded responses 37 check-ins 12 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 852 / AZ
Registered: 2021-03-05

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

2021-03-03
Dose 1 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Retching — Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness

Free text: Dry Heaves

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Retching — Feeling: Fair · Site: Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dry hraves

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — day 14, dose 1
MedDRA: Asthenia, Dyspnoea exertional, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired, after making my bed in the morning, I'm WINDED! LACK OF energy!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Sore, very sore Throat!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 7, dose 2
MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Still Sore throat, heavy cough

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

Adult check-in
2021-04-21
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-31
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-15
Dose 3 — Moderna
2022-04-27
Survey response — day 7, dose 3
MedDRA: Heart rate irregular, Hyperhidrosis — Feeling: Fair · Fatigue or tiredness · 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: Irregular heartbeat. Also, sweating of the body.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-29
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-05-02
Call 1 — Left Voicemail
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-05-06
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-05-13
Survey response — day 28, dose 3
MedDRA: Heart rate irregular, Unevaluable event — 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: Symptoms: Irregular heartbeat. I've been wearing a heart monitor for the last 10 days. Prognosis at this time is undetermined. (b)(6) · Healthcare visit (other): Scheduled meeting with primary care physician and cardiologist.

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-20
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-05-27
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-07-17
Survey response — 3 months, dose 3
MedDRA: Cough — Feeling: Good

Free text: Deep cough that is getting better this week.

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-11
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-17
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-02
Survey response — day 28, dose 4
MedDRA: Heart rate irregular — Feeling: Poor · 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

Free text: Irregular heartbeat. Apparently I've had a regular heartbeat for a few months now and I'm not sure if they're caused by the vaccinations of the COVID-19 site. I will check with my cardiologist. Please follow up with me if there's an indication!

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Report sent to call center — day 28, dose 4
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 · 1 call case(s)
2022-11-03
Call 1 — Requested Callback
2022-11-03
Callback requested for
01:30PM ET
2022-11-03
Call successful
Completed over the phone
2022-11-12
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-14
Survey response — day 42, dose 4
MedDRA: Fatigue, Heart rate irregular, Hyperhidrosis, Office visit, Poor quality sleep — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, tired, not sleeping well, excessive sweating, continuing to have irregular heartbeat. · Healthcare visit (other): Office visit with doctor Freij cardiologist.

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Report sent to call center — day 42, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-11-15
Call 1 — Left Voicemail
2023-01-02
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-05
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2022-04-15	Moderna	No
4	2022-10-03	Pfizer-BioNTech	Flu

Call center

4 call center cases

3 successful · 1 unsuccessful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Dry Heaves

2021-03-09

Systemic reaction (other): Dry hraves

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Tired, after making my bed in the morning, I'm WINDED! LACK OF energy!

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Sore throat

2021-04-05

Systemic reaction (other): Sore throat

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Sore, very sore Throat!

Release 7 — day 7, dose 2

2021-04-07

Systemic reaction (other): Still Sore throat, heavy cough

Release 11 — day 7, dose 3

2022-04-27

Systemic reaction (other): Irregular heartbeat. Also, sweating of the body.

Release 11 — day 28, dose 3

2022-05-13

Symptoms: Irregular heartbeat. I've been wearing a heart monitor for the last 10 days. Prognosis at this time is undetermined. (b)(6)

Healthcare visit (other): Scheduled meeting with primary care physician and cardiologist.

redacted (b)(6)

Release 12 — 3 months, dose 3

2022-07-17

Symptoms: Deep cough that is getting better this week.

Release 12 — day 28, dose 4

2022-11-02

Symptoms: Irregular heartbeat. Apparently I've had a regular heartbeat for a few months now and I'm not sure if they're caused by the vaccinations of the COVID-19 site. I will check with my cardiologist. Please follow up with me if there's an indication!

Release 12 — day 42, dose 4

2022-11-14

Symptoms: Fatigue, tired, not sleeping well, excessive sweating, continuing to have irregular heartbeat.

Healthcare visit (other): Office visit with doctor Freij cardiologist.

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	Unevaluable event	·	·	✓
SD	Asthenia	✓	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Poor quality sleep	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Heart rate irregular	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Retching	✓	✓	✓

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