Y2L-27395-25174

4 vaccinations 16 coded responses 51 check-ins 16 free-text entries 5 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 207 / MD
Registered: 2021-03-12

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-11
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 21, dose 1
MedDRA: Cough, Diarrhoea, Wheezing — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Dry cough, wheezing, occasional diarrhea

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

1 call case(s)
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I weird, indescribable feeling of being off? Its hard to explain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath, difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness

Free text: Shortness of breath, difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dyspnoea — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: Dry cough, some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 21, dose 2
MedDRA: Pharyngitis streptococcal, Streptococcus test positive — Feeling: Fair · Be unable to work, 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: I had a strep throat test that came back positive yesterday. I am on penicillin to treat it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
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)
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Survey response — 6 months, dose 2
MedDRA: Cough, Diarrhoea, Fatigue, Nausea — Feeling: Good · Be unable to work or attend school, 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: I had a lingering cough that didn't go away for a month. I tried to be seen by my PCP but he was refusing to see any patients at all who had a cough. I also had a weekend of nausea, diarrhea, and fatigue that my wife had as well.

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-08
Call successful
Participant prefers to complete VAERS report online
2021-10-29
Dose 3 — Moderna
Co-administered: Flu
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain, Pain — Feeling: Good · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Free text: It hurts to raise the injection arm too high above my head, at the injection sites

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Dyspepsia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Heartburn

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Dysphagia, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Trouble swallowing, sore throat, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea, Sinus congestion — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Running nose and sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — day 7, dose 3
MedDRA: Ear pain, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion, runny nose, sore throat, ear pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Survey response — day 14, dose 3
MedDRA: Enlarged uvula, Gastrooesophageal reflux disease, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Nocturnal acid reflux leading to vomit and swollen uvula

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-08
Dose 4 — Moderna
2022-09-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-09-17
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-09-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-20
Survey response — day 42, dose 4
MedDRA: Cough, Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Upper respiratory infection: headaches, fatigue, runny nose, sore throat, cough, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Survey response — 3 months, dose 4
MedDRA: Cough, Exposure to SARS-CoV-2, Feeling abnormal, Influenza virus test negative, Insomnia, Oropharyngeal pain, Pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · 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

Free text: Intense cough with no relief, loss of sleep, sore throat, runny nose, body aches. My wife and 2 year old son tested positive for COVID, and I felt worse than I ever had in my life I consistently tested negative for Covid as well as flu and rsv

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-09
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-10-29	Moderna	Flu
4	2022-09-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-10	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-29	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-10-07	Successful 2021-10-08	Participant prefers to complete VAERS report online
2022-12-08	Successful 2022-12-09	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Dry cough, wheezing, occasional diarrhea

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): I weird, indescribable feeling of being off? Its hard to explain.

2021-04-10

Systemic reaction (other): Shortness of breath, difficulty breathing

2021-04-11

Systemic reaction (other): Shortness of breath, difficulty breathing

2021-04-12

Systemic reaction (other): Shortness of breath

2021-04-13

Systemic reaction (other): Dry cough, some shortness of breath

Release 8 — day 21, dose 2

2021-04-29

Symptoms: I had a strep throat test that came back positive yesterday. I am on penicillin to treat it.

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: I had a lingering cough that didn't go away for a month. I tried to be seen by my PCP but he was refusing to see any patients at all who had a cough. I also had a weekend of nausea, diarrhea, and fatigue that my wife had as well.

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): It hurts to raise the injection arm too high above my head, at the injection sites

2021-11-02

Systemic reaction (other): Heartburn

2021-11-03

Systemic reaction (other): Trouble swallowing, sore throat, nasal congestion

2021-11-04

Systemic reaction (other): Running nose and sinus congestion

Release 10 — day 7, dose 3

2021-11-05

Systemic reaction (other): Congestion, runny nose, sore throat, ear pain

Release 10 — day 14, dose 3

2021-11-12

Symptoms: Nocturnal acid reflux leading to vomit and swollen uvula

Release 12 — day 42, dose 4

2022-10-20

Symptoms: Upper respiratory infection: headaches, fatigue, runny nose, sore throat, cough, etc.

Release 12 — 3 months, dose 4

2022-12-08

Symptoms: Intense cough with no relief, loss of sleep, sore throat, runny nose, body aches. My wife and 2 year old son tested positive for COVID, and I felt worse than I ever had in my life I consistently tested negative for Covid as well as flu and rsv

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
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Enlarged uvula	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Insomnia	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pharyngitis streptococcal	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Streptococcus test positive	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Vomiting	·	·	✓
SD	Wheezing	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspepsia	·	·	✓
SRO	Dysphagia	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sinus congestion	·	·	✓

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