6Q4-23605-01046

2 vaccinations 7 coded responses 7 check-ins 7 free-text entries 7 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 154 / PA
Registered: 2021-03-10

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

2021-01-22
Dose 1 — Moderna
2021-02-19
Dose 2 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Survey response — day 14, dose 2
MedDRA: Cerebrovascular accident, Impaired work ability, Intensive care, Malaise, Thrombosis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: I am writing for Steve. He was too sick on Saturday, Sunday and Monday to work after the second shot. 6 days later on February 28 he had a devastating blood clot and stroke. Steve is a really healthy health care worker and not on any meds. OMG! · Healthcare visit (other): Stroke ICU at (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
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)
2021-03-12
Survey response — day 21, dose 2
MedDRA: Cerebrovascular accident, Rehabilitation therapy — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Stroke · Healthcare visit (other): Stroke rehab now at (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 21, 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)
2021-03-21
Survey response — day 28, dose 2
MedDRA: Cerebrovascular accident, Hospitalisation — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Stroke · Healthcare visit (other): ICU, neuro-trauma, rehab hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
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)
2021-03-26
Survey response — day 35, dose 2
MedDRA: Cerebrovascular accident, Hospitalisation — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Stroke · Healthcare visit (other): Rehabilitation hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
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)
2021-04-02
Survey response — day 42, dose 2
MedDRA: Cerebrovascular accident, Medical observation — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Stroke: brain stem · Healthcare visit (other): Rehab hospital and skilled nursing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 42, 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)
2021-05-22
Survey response — 3 months, dose 2
MedDRA: Cerebrovascular accident, Hospitalisation, Impaired driving ability, Impaired work ability, Medical counselling, Mobility decreased, Unevaluable event, Wheelchair user — 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Stroke, swallowing, walking, sleep. Have to get rides for doctor appointments. Had to apply for disability. Cannot work. In wheelchair. Sent my medical records to CDC and you for review. · Healthcare visit (other): Rehab Hospital, nursing home and now home health care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — 3 months, 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)
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Brain stem stroke, Disability, Dysphagia, Eating disorder, Gait disturbance, Home care, Impaired work ability, Living in residential institution, Medical counselling, Occupational therapy, Physiotherapy, Rehabilitation therapy — 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Brain stem stroke has caused extensive disabilities with swallowing, walking, eating, etc. I will not be able to work and have had to apply for social security disability. No one from the CDC has even contacted me after I sent all medical record. · Healthcare visit (other): Emcompass Rwhab, nursing home, home health OT, PT, Speech, nursing, home health aid.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 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)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna

Call center

7 call center cases

7 successful

VAERS report filed, before or during a call: 7

See the call center timeline

Free text

Release 5 — day 14, dose 2

2021-03-10

Symptoms: I am writing for Steve. He was too sick on Saturday, Sunday and Monday to work after the second shot. 6 days later on February 28 he had a devastating blood clot and stroke. Steve is a really healthy health care worker and not on any meds. OMG!

Healthcare visit (other): Stroke ICU at (b)(6)

redacted (b)(6)

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Stroke

Healthcare visit (other): Stroke rehab now at (b)(6)

redacted (b)(6)

Release 6 — day 28, dose 2

2021-03-21

Symptoms: Stroke

Healthcare visit (other): ICU, neuro-trauma, rehab hospital

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Stroke

Healthcare visit (other): Rehabilitation hospital

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Stroke: brain stem

Healthcare visit (other): Rehab hospital and skilled nursing.

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: Stroke, swallowing, walking, sleep. Have to get rides for doctor appointments. Had to apply for disability. Cannot work. In wheelchair. Sent my medical records to CDC and you for review.

Healthcare visit (other): Rehab Hospital, nursing home and now home health care

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Brain stem stroke has caused extensive disabilities with swallowing, walking, eating, etc. I will not be able to work and have had to apply for social security disability. No one from the CDC has even contacted me after I sent all medical record. cut off by CDC

Healthcare visit (other): Emcompass Rwhab, nursing home, home health OT, PT, Speech, nursing, home health aid.

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	Cerebrovascular accident	✓	✓	✓
HCVO	Home care	✓	·	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Intensive care	✓	✓	✓
HCVO	Living in residential institution	✓	·	✓
HCVO	Medical counselling	✓	·	✓
HCVO	Medical observation	✓	✓	✓
HCVO	Occupational therapy	✓	·	✓
HCVO	Physiotherapy	✓	·	✓
HCVO	Rehabilitation therapy	✓	✓	✓
HCVO	Unevaluable event	○	✓	○
SD	Brain stem stroke	✓	·	✓
SD	Cerebrovascular accident	✓	✓	✓
SD	Disability	✓	·	✓
SD	Dysphagia	✓	·	✓
SD	Eating disorder	✓	·	✓
SD	Gait disturbance	✓	·	✓
SD	Impaired driving ability	✓	·	✓
SD	Impaired work ability	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Mobility decreased	○	✓	○
SD	Thrombosis	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Wheelchair user	✓	·	✓

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