6AU-22068-55206

3 vaccinations 10 coded responses 30 check-ins 10 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 857 / AZ
Registered: 2021-01-06

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Moderna
2021-02-10
Survey response — day 7, dose 2
MedDRA: Chills — Feeling: Good · Site: Pain, Itching

Free text: Chills 2nd night after 2nd shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Pyrexia — Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Free text: Yesterday had fatigue and feverish feeling

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling hot — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Free text: Feel feverish without actual fever

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Pyrexia — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Feverishness

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling cold — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Chilliness

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-29
Survey response — day 7, dose 3
MedDRA: Flushing — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Flushed feeling

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — day 14, dose 3
MedDRA: Fatigue, Feeling cold, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Continuing fatigue and chilliness, about same as last week · Healthcare visit (other): Going to see my doctor later today

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
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)
2021-11-09
Call 1 — Left Voicemail
2021-11-09
Call 1 — Left Voicemail
2021-11-11
Call successful
Participant prefers to complete VAERS report online
2021-11-12
Health check-in — day 21, dose 3
Feeling: Poor

Adult check-in
2021-11-19
Survey response — day 28, dose 3
MedDRA: Fatigue, Flushing, Malaise, Pyrexia — Feeling: Poor · 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: Persistent feverishness, flushing, fatigue and malaise for 1 month now, please contact me at (b)(6) or (b)(6)

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-23
Call 1 — Left Voicemail
2021-11-23
Call 2 — Left Voicemail
2021-11-26
Survey response — day 35, dose 3
MedDRA: Asthenia, Fatigue, Office visit, Pyrexia — 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: Continuing fatigue, weakness, feverish feelings, seeing doctor several times about this 5 wks after Moderna booster

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Report sent to call center — day 35, 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)
2021-11-29
Call 3 — Left Voicemail
2021-12-03
Survey response — day 42, dose 3
MedDRA: Asthenia, Fatigue — Feeling: Poor · 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: More fatigue and weakness when walking

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-03
Call 2 — Left Voicemail
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-22
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna
3	2021-10-22	Moderna	No

Call center

4 call center cases

1 successful · 3 unsuccessful

See the call center timeline

Free text

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): Chills 2nd night after 2nd shot

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Yesterday had fatigue and feverish feeling

2021-10-25

Systemic reaction (other): Feel feverish without actual fever

2021-10-26

Systemic reaction (other): Feverishness

2021-10-27

Systemic reaction (other): Chilliness

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): Flushed feeling

Release 10 — day 14, dose 3

2021-11-05

Symptoms: Continuing fatigue and chilliness, about same as last week

Healthcare visit (other): Going to see my doctor later today

Release 10 — day 28, dose 3

2021-11-19

Symptoms: Persistent feverishness, flushing, fatigue and malaise for 1 month now, please contact me at (b)(6) or (b)(6)

redacted (b)(6)

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Continuing fatigue, weakness, feverish feelings, seeing doctor several times about this 5 wks after Moderna booster

Release 10 — day 42, dose 3

2021-12-03

Symptoms: More fatigue and weakness when walking

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	Unevaluable event	·	·	✓
SD	Asthenia	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling cold	·	·	✓
SD	Flushing	·	·	✓
SD	Malaise	·	·	✓
SD	Office visit	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Feeling cold	·	·	✓
SRO	Feeling hot	·	·	✓
SRO	Flushing	·	·	✓
SRO	Pyrexia	·	·	✓

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