Y3D-91281-75295

5 vaccinations 12 coded responses 38 check-ins 11 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 223 / VA
Registered: 2021-02-15

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
2021-02-15
Registered in v-safe
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Musculoskeletal discomfort — Feeling: Good · Headache

Free text: On 24 Feb, felt some discomfort around upper back and slight headache from about 3pm til I went to bet an hour early at 10pm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-06
Survey response — day 42, dose 2
MedDRA: Body temperature normal, Nausea — Feeling: Good

Free text: Last Friday afternoon, I was nauseated. Felt ill for about 2 hours. Normal temperature. No other problems.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Myalgia, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Arm shoulder muscle ache.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: No.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-06
Dose 4 — Moderna
2022-04-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-18
Survey response — day 42, dose 4
MedDRA: Computerised tomogram abnormal — Feeling: Good · 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: Ct-scan found lesion on my pancreas and lesion on my liver.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-19
Call 2 — Left Voicemail
2022-07-06
Survey response — 3 months, dose 4
MedDRA: Emergency care, Pancreatic carcinoma metastatic, Pancreatic carcinoma stage IV — Feeling: Good

Free text: No COVID. Was sent to hospital from ship in Brussels. Have metastatic stage 4 pancreatic cancer.

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Dose 5 — Moderna
Co-administered: Flu
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Slight woosy feeling yesterday.

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Survey response — days 1–6 daily, dose 5
MedDRA: Sinus headache — Feeling: Good · Headache

Free text: Slight sinus headache?

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-03
Survey response — days 1–6 daily, dose 5
MedDRA: Chemotherapy, Pancreatic carcinoma metastatic — Feeling: Good

Free text: Got infusion of chemo for Stage 4 pancreatic cancer this morning.Carrying pump for next two days.

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-07
Survey response — day 7, dose 5
MedDRA: Nausea — Feeling: Good · Nausea

Free text: Mild nausea. Maybe because of chemo.

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-19
Survey response — day 21, dose 5
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Because of chemo, I seem to be getting tired more.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-04
Survey response — 6 months, dose 5
MedDRA: Influenza virus test positive, Laboratory test abnormal, SARS-CoV-2 test positive — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-04
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-05
Call 1 — Left Voicemail
2023-04-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-23	Moderna
3	2021-10-26	Moderna	No
4	2022-04-06	Moderna	No
5	2022-09-28	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-05-18	Unsuccessful
2023-04-04	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): On 24 Feb, felt some discomfort around upper back and slight headache from about 3pm til I went to bet an hour early at 10pm.

Release 7 — day 42, dose 2

2021-04-06

Symptoms: Last Friday afternoon, I was nauseated. Felt ill for about 2 hours. Normal temperature. No other problems.

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Arm shoulder muscle ache.

2021-10-29

Systemic reaction (other): No.

Release 11 — day 42, dose 4

2022-05-18

Symptoms: Ct-scan found lesion on my pancreas and lesion on my liver.

Release 12 — 3 months, dose 4

2022-07-06

Symptoms: No COVID. Was sent to hospital from ship in Brussels. Have metastatic stage 4 pancreatic cancer.

Release 12 — days 1–6 daily, dose 5

2022-09-30

Systemic reaction (other): Slight woosy feeling yesterday.

2022-10-01

Systemic reaction (other): Slight sinus headache?

2022-10-03

Systemic reaction (other): Got infusion of chemo for Stage 4 pancreatic cancer this morning.Carrying pump for next two days.

Release 12 — day 7, dose 5

2022-10-07

Systemic reaction (other): Mild nausea. Maybe because of chemo.

Release 12 — day 21, dose 5

2022-10-19

Symptoms: Because of chemo, I seem to be getting tired more.

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	Laboratory test abnormal	·	·	✓
SD	Body temperature normal	✓	✓	✓
SD	Computerised tomogram abnormal	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Influenza virus test positive	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pancreatic carcinoma metastatic	·	·	✓
SD	Pancreatic carcinoma stage IV	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Chemotherapy	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Pancreatic carcinoma metastatic	·	·	✓
SRO	Sinus headache	·	·	✓

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