YCC-32266-89845

3 vaccinations 8 coded responses 36 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 787 / TX
Registered: 2021-03-11

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Health check-in — day 0, dose 1
Feeling: Poor · Site: Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Pulmonary congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lung congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good

Free text: persistent cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — day 14, dose 1
MedDRA: Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: A probably unrelated sinus infection has set in over the last few days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 21, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Stomach upset (cramping, loose stool, nausea) for the last few weeks. Probably unrelated (IBS-C diagnosis 2018) vertigo for two days last weekend (Meneieres diagnosis 2003) also probably unrelated.

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
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Fair · Site: Itching · Fever · Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Feels like i have pneumonia.

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: Bronchospasm, Meniere's disease, Pre-existing disease, Respiratory tract irritation — Feeling: Good · Site: Pain

Free text: Lungs are still irritated. The sensation of lung constriction passed Saturday night. Was enjoying Menieres symptoms yesterday so forgot to check in.

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 · Site: Pain · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Hypersensitivity, Infection, Pre-existing disease, Quarantine — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have caught some form of infection at least once. I isolated and it passed in a reasonable time. I suffer from airborne allergies and I'm not even certain that it wasn't an allergic reaction. Currently having allergic reactions.

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Dose 3 — Moderna
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion — Feeling: Good · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Abdominal pain

Free text: All of the symptoms were much worse 48 hours ago and included chest congestion similar in feeling to Pneumonia. That eased off after twenty-four hours. Yesterday was moderate on all symptoms.

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling, Itching · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Abdominal pain

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-16
Health check-in — day 7, dose 3
Feeling: Good · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-12-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-09
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-09	Moderna
3	2021-12-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Successful 2021-06-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Lung congestion

2021-03-16

Systemic reaction (other): persistent cough

Release 6 — day 14, dose 1

2021-03-25

Symptoms: A probably unrelated sinus infection has set in over the last few days

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Stomach upset (cramping, loose stool, nausea) for the last few weeks. Probably unrelated (IBS-C diagnosis 2018) vertigo for two days last weekend (Meneieres diagnosis 2003) also probably unrelated.

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Feels like i have pneumonia.

2021-04-12

Systemic reaction (other): Lungs are still irritated. The sensation of lung constriction passed Saturday night. Was enjoying Menieres symptoms yesterday so forgot to check in.

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: I have caught some form of infection at least once. I isolated and it passed in a reasonable time. I suffer from airborne allergies and I'm not even certain that it wasn't an allergic reaction. Currently having allergic reactions.

Release 10 — days 1–6 daily, dose 3

2021-12-12

Systemic reaction (other): All of the symptoms were much worse 48 hours ago and included chest congestion similar in feeling to Pneumonia. That eased off after twenty-four hours. Yesterday was moderate on all symptoms.

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	Condition aggravated	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Infection	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Quarantine	·	·	✓
SD	Sinusitis	✓	✓	✓
SRO	Bronchospasm	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Meniere's disease	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pulmonary congestion	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Respiratory tract irritation	✓	✓	✓

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