YHB-32606-91198

2 vaccinations 9 coded responses 17 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 891 / NV
Registered: 2021-05-22

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

2021-05-22
Registered in v-safe
2021-05-22
Dose 1 — Moderna
2021-05-22
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy & light headed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-05-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Abdominal pain

Adult check-in
2021-05-29
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-06-07
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Fatigue, Injection site pain — Feeling: Fair

Free text: Very loose stool , fatigue , arm where shot was givin is sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-06-22
Dose 2 — Moderna
2021-06-22
Survey response — day 0, dose 2
MedDRA: Cough, Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy soar through coughing. Cant clear throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — days 1–6 daily, dose 2
MedDRA: Visual impairment — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Eyesight is bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-07-01
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: Headache is very consistent.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Survey response — day 14, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: It seems my arms are not healing very fast. They just hurt when using them at work , & never seem to heal from that shot & the pain the shot caused.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-15
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-07-20
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-07-29
Survey response — day 35, dose 2
MedDRA: Cardiac disorder, Emergency care, Lung disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart problems. Had to go to ER. Since 2nd shot Ive not been able to clear my lungs either.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Survey response — day 42, dose 2
MedDRA: Angina pectoris, Emergency care — Feeling: Fair · Be unable to work or attend school, 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: Heart pain. Went to ER Sunday

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Report sent to call center — day 42, 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

1 call case(s)
2021-08-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-22	Moderna
2	2021-06-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-03	Unsuccessful

Free text

Release 8 — day 0, dose 1

2021-05-22

Systemic reaction (other): Dizzy & light headed.

Release 8 — day 14, dose 1

2021-06-07

Symptoms: Very loose stool , fatigue , arm where shot was givin is sore.

Release 9 — day 0, dose 2

2021-06-22

Systemic reaction (other): Dizzy soar through coughing. Cant clear throat

Release 9 — days 1–6 daily, dose 2

2021-06-23

Systemic reaction (other): No

2021-06-24

Systemic reaction (other): Eyesight is bad

Release 9 — day 7, dose 2

2021-07-01

Systemic reaction (other): Headache is very consistent.

Release 9 — day 14, dose 2

2021-07-08

Symptoms: It seems my arms are not healing very fast. They just hurt when using them at work , & never seem to heal from that shot & the pain the shot caused.

Release 9 — day 35, dose 2

2021-07-29

Symptoms: Heart problems. Had to go to ER. Since 2nd shot Ive not been able to clear my lungs either.

Release 9 — day 42, dose 2

2021-08-03

Symptoms: Heart pain. Went to ER Sunday

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	Angina pectoris	✓	·	✓
SD	Cardiac disorder	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Lung disorder	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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