6T8-17005-72534

4 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 992 / WA
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Swelling face — Feeling: Good · Site: Pain

Free text: Next day less than 24 hrs after receiving vaccine developed small red bump (about 4mm) tall with diameter equal to a pencil eraser on right cheek. Maybe just coincidental. However, I'm not a person that gets those types of things randomly. Have not been in areas with mosquitoes either. Climate is winter in my geographic location so no mosquitoes present.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Nausea

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Diarrhoea — Feeling: Good · Be unable to work

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to work

1 call case(s)
2021-01-20
Survey response — day 21, dose 1
MedDRA: Haematuria, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lab result from employer required medical physical with - Hematuria detected · Healthcare visit (other): Employer required yearly medical evaluation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-26
Call successful
Does not wish to fill out VAERS report
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-16
Dose 3 — Pfizer-BioNTech
2022-01-29
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-01-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-19
Survey response — 3 months, dose 3
MedDRA: Musculoskeletal pain, Pain in extremity — Feeling: Fair

Free text: Random Transient sharp musculoskeletal pains in various body parts. Hands, legs, feet, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Dose 4 — Moderna
Co-administered: Flu
2022-12-16
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-26	Moderna
3	2021-12-16	Pfizer-BioNTech	No
4	2022-11-07	Moderna	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Next day less than 24 hrs after receiving vaccine developed small red bump (about 4mm) tall with diameter equal to a pencil eraser on right cheek. Maybe just coincidental. However, I'm not a person that gets those types of things randomly. Have not been in areas with mosquitoes either. Climate is winter in my geographic location so no mosquitoes present.

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Diarrhea

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Lab result from employer required medical physical with - Hematuria detected

Healthcare visit (other): Employer required yearly medical evaluation

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Vertigo

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Night sweats

Release 11 — 3 months, dose 3

2022-03-19

Symptoms: Random Transient sharp musculoskeletal pains in various body parts. Hands, legs, feet, etc.

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	Medical counselling	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Haematuria	✓	✓	✓
SD	Musculoskeletal pain	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Night sweats	✓	✓	✓
SRO	Swelling face	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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