5YX-22049-97362

5 vaccinations 29 coded responses 58 check-ins 21 free-text entries 13 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 985 / WA
Registered: 2021-04-03

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

2021-04-02
Dose 1 — Moderna
2021-04-03
Registered in v-safe
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Poor quality sleep — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: poor sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-06
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 7, dose 1
Feeling: Poor · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Survey response — day 14, dose 1
MedDRA: Back pain, Headache, Neck pain — Feeling: Fair · Be unable to work, 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: pain between left scapula and spine and in neck (muscle spasm?) accompanied by headache since 4/3, ranges from moderate to severe for past week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-30
Dose 2 — Moderna
2021-04-30
Survey response — day 0, dose 2
MedDRA: Neuralgia — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · 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: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Fair · Headache, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia — Feeling: Fair · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 7, dose 2
MedDRA: Neuralgia — Feeling: Fair · Headache, Muscle or body aches

Free text: nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 14, dose 2
MedDRA: Neuralgia — Feeling: Fair · Be unable to work, 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: continued severe nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Survey response — day 21, dose 2
MedDRA: Neuralgia — 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: intense nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
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)
2021-05-30
Survey response — day 28, dose 2
MedDRA: Neck pain — Feeling: Poor · Be unable to work, 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: increased nerve pain, c7 and c8 nerves left side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Survey response — day 35, dose 2
MedDRA: Neuralgia, Radiculopathy — Feeling: Poor · Be unable to work, 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: nerve pain, radiculopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Survey response — day 42, dose 2
MedDRA: Cervical radiculopathy, Neuralgia, Radiculopathy — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Cervical nerve pain, radiculopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — day 42, dose 2
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)
2021-06-17
Call 1 — Left Voicemail
2021-08-01
Survey response — 3 months, dose 2
MedDRA: Diarrhoea, Hypoaesthesia — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Diarrhea, numbness in heels, possible Parsonage Turner Syndrom.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-01
Report sent to call center — 3 months, dose 2
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)
2021-08-13
Call 1 — Left Voicemail
2021-10-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-15
Dose 3 — Moderna
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-22
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-05
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-28
Dose 4 — Moderna
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-04
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2022-06-11
Survey response — day 14, dose 4
MedDRA: Diarrhoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: extreme fatigue, diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-06-18
Survey response — day 21, dose 4
MedDRA: Back pain, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: low back spasm/pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-09
Survey response — day 42, dose 4
MedDRA: Fatigue — Feeling: Good

Free text: extreme fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-08-27
Survey response — 3 months, dose 4
MedDRA: Malaise, SARS-CoV-2 test positive — 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: SARS-coV-2 symptoms & positive test result yesterday

MedDRA releases: 2024-11 · check-in free text available
2022-08-27
Report sent to call center — 3 months, 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)
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-08-31
Call successful
Participant prefers to complete VAERS report online
2022-11-26
Survey response — 6 months, dose 4
MedDRA: Neuralgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: nerve pain in hands

MedDRA releases: 2024-11 · check-in free text available
2022-11-26
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-29
Call 1 — Left Voicemail
2023-01-14
Dose 5 — Pfizer-BioNTech
2023-01-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2023-01-17
Survey response — days 1–6 daily, dose 5
MedDRA: Tinnitus — Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea, Diarrhea

MedDRA releases: 2024-11
2023-01-18
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog, Fatigue, Mental impairment, Post-acute COVID-19 syndrome, Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea

MedDRA releases: 2024-11
2023-01-19
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog, Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

MedDRA releases: 2024-11
2023-01-20
Survey response — days 1–6 daily, dose 5
MedDRA: Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11
2023-01-21
Survey response — day 7, dose 5
MedDRA: Depression, Tinnitus — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-01-28
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-02-04
Survey response — day 21, dose 5
MedDRA: Tinnitus — Feeling: Good

MedDRA releases: 2024-11
2023-02-11
Survey response — day 28, dose 5
MedDRA: Diarrhoea, Fatigue — Feeling: Fair

MedDRA releases: 2024-11
2023-02-18
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-02-27
Survey response — day 42, dose 5
MedDRA: Diarrhoea — Feeling: Good

MedDRA releases: 2024-11
2023-04-17
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-02	Moderna
2	2021-04-30	Moderna
3	2021-12-15	Moderna	No
4	2022-05-28	Moderna	No
5	2023-01-14	Pfizer-BioNTech	No

Call center

13 call center cases

12 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-04

Systemic reaction (other): poor sleep

Release 7 — day 14, dose 1

2021-04-16

Symptoms: pain between left scapula and spine and in neck (muscle spasm?) accompanied by headache since 4/3, ranges from moderate to severe for past week.