69B-33979-53279

2 vaccinations 4 coded responses 25 check-ins 4 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 762 / TX
Registered: 2021-02-01

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

2021-02-01
Registered in v-safe
2021-02-01
Dose 1 — Moderna
2021-02-01
Health check-in — day 0, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

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

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

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Survey response — day 21, dose 2
MedDRA: Influenza, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nothing related to COVID-19, but I was diagnosed with Flu A today. · Healthcare visit (other): PCP visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 35, dose 2
MedDRA: Chills, Emergency care, Hospitalisation, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Had a fever and infection not related to vaccination. After stint removal from bile duct (installed during gall bladder removal before vaccinations), developed fever and chills. Went to hospital ER and still am in hospital.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Survey response — 3 months, dose 2
MedDRA: Platelet count decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Low blood platelet count. Not sure if there is any correlation to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call 1 — Left Voicemail
2021-06-30
Call successful
Participant prefers to complete VAERS report online
2021-08-30
Survey response — 6 months, dose 2
MedDRA: SARS-CoV-2 test, Viral infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Viral infection after trip to (b)(6). Tested for Covid before return home and after I returned.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-01	Moderna

Call center

4 call center cases

4 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Nothing related to COVID-19, but I was diagnosed with Flu A today.

Healthcare visit (other): PCP visit

Release 6 — day 35, dose 2

2021-04-05

Symptoms: Had a fever and infection not related to vaccination. After stint removal from bile duct (installed during gall bladder removal before vaccinations), developed fever and chills. Went to hospital ER and still am in hospital.

Release 8 — 3 months, dose 2

2021-05-31

Symptoms: Low blood platelet count. Not sure if there is any correlation to vaccine.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Viral infection after trip to (b)(6). Tested for Covid before return home and after I returned.

redacted (b)(6)

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	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Influenza	✓	✓	✓
SD	Platelet count decreased	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test	✓	·	✓
SD	Viral infection	✓	·	✓

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