6YB-18151-64724

2 vaccinations 6 coded responses 25 check-ins 6 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 431 / OH
Registered: 2021-01-23

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Moderna
2021-01-23
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Loss of consciousness — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Passed out and needed assistance to get up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — day 7, dose 1
MedDRA: Asthenia, Emergency care, Lung opacity, Pneumonia, Urinary tract infection — Feeling: Poor · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: He went to the ER last night and discovered that his weakness was caused by a UTI. His X-ray showed opacity in the left lung so he is taking an antibiotic for pneumonia and UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Survey response — day 14, dose 1
MedDRA: Blood pressure increased, Computerised tomogram abnormal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Emergency care, Fall, General physical health deterioration, Pneumonia, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I visited the ER on 1/29 due to a fall. Diagnosis was UTI and pneumonia. I returned to the ER on 2/1 due to declining health. Medication for UTI further diminished my health with escalating blood pressure and chest CT scan showing pneumonia presence.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-20
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Asthenia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-27
Call successful
Participant prefers to complete VAERS report online
2021-08-21
Survey response — 6 months, dose 2
MedDRA: Arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hip and knee arthritis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-20
Survey response — 12 months, dose 2
MedDRA: Cervical vertebral fracture, Fall — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: I fell and fractured 3 vertebrae in my neck on 12/19/21.

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-02-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-02-20	Moderna

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Passed out and needed assistance to get up

Release 3 — day 7, dose 1

2021-01-30

Healthcare visit (other): He went to the ER last night and discovered that his weakness was caused by a UTI. His X-ray showed opacity in the left lung so he is taking an antibiotic for pneumonia and UTI

Release 3 — day 14, dose 1

2021-02-06

Symptoms: I visited the ER on 1/29 due to a fall. Diagnosis was UTI and pneumonia. I returned to the ER on 2/1 due to declining health. Medication for UTI further diminished my health with escalating blood pressure and chest CT scan showing pneumonia presence. cut off by CDC

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Weakness

Release 9 — 6 months, dose 2

2021-08-21

Symptoms: Hip and knee arthritis

Release 11 — 12 months, dose 2

2022-02-20

Symptoms: I fell and fractured 3 vertebrae in my neck on 12/19/21.

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	Asthenia	✓	✓	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Lung opacity	✓	✓	✓
HCVO	Pneumonia	✓	✓	✓
HCVO	Urinary tract infection	✓	✓	✓
SD	Arthritis	✓	·	✓
SD	Asthenia	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Cervical vertebral fracture	·	·	✓
SD	Computerised tomogram abnormal	○	✓	○
SD	Computerised tomogram thorax	○	✓	○
SD	Computerised tomogram thorax abnormal	✓	·	✓
SD	Emergency care	✓	✓	✓
SD	Fall	✓	✓	✓
SD	General physical health deterioration	✓	·	✓
SD	Pneumonia	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓

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