YLA-31869-76450

3 vaccinations 7 coded responses 10 check-ins 7 free-text entries 4 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 551 / MN
Registered: 2021-05-19

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

2021-04-22
Dose 1 — Moderna
2021-05-19
Registered in v-safe
2021-05-19
Survey response — day 21, dose 1
MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe joint pain in my SI joint. This was already inflamed prior to vaccination and i was working with a chiropractor. We were ready to finish treatment but after receiving Dose 1 it flared up and has been very painful. · Healthcare visit (other): Chiropractic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Dose 2 — Moderna
2021-05-21
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

Adult check-in
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-05-30
Survey response — day 7, dose 2
MedDRA: Arthritis, Tinnitus — Feeling: Good · Joint pains

Free text: The vaccine inflamed my SI joint. I also have very loud, high pitched ringing in my ears that started the day after receiving my second dose and has not gone away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 14, dose 2
MedDRA: Office visit, Sacral pain, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My SI joint is still incredibly painful and the ringing in my ears that started after the vaccine has not subsided yet. · Healthcare visit (other): Chiropractor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-19
Survey response — 3 months, dose 2
MedDRA: Office visit, Sacral pain, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I still have significant tinnitus which was caused by my vaccine. It has not diminished or gone away. I also have severe SI joint pain which i an working with a chiropractor to alleviate. · Healthcare visit (other): Chiropractic

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-23
Call 1 — Left Voicemail
2021-11-20
Dose 3 — Moderna
2021-11-29
Survey response — day 7, dose 3
MedDRA: Tinnitus, Vaccine positive rechallenge — Feeling: Good

Free text: I got tinnitus from my 2nd dose. My symptoms had improved slightly but my booster brought me right back to where I was right after receiving my 2nd dose.

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Survey response — 6 months, dose 3
MedDRA: Tinnitus — Feeling: Fair

Free text: My tinnitus that resulted from the vaccine is still present. It has not improved.

MedDRA releases: 2024-11 · check-in free text available
2022-11-20
Survey response — 12 months, dose 3
MedDRA: Discomfort, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: After receiving my bivalent booster my vaccine induced tinnitus is uncomfortably loud and piercing. I have an appointment with an ENT to discuss my symptoms. As a reminder, I got tinnitus within 48 hours after receiving first vaccine dose.

MedDRA releases: 2024-11 · check-in free text available
2022-11-20
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-21
Call 1 — Left Voicemail
2022-11-21
Call 1 — Left Voicemail
2022-11-21
Call 2 — Left Voicemail
2022-11-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Moderna
2	2021-05-20	Moderna
3	2021-11-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-19	Unsuccessful
2021-06-03	Unsuccessful	Reported to VAERS voluntarily prior to GDIT contact
2021-08-19	Unsuccessful	Reported to VAERS voluntarily prior to GDIT contact
2022-11-20	Unsuccessful

Free text

Release 8 — day 21, dose 1

2021-05-19

Symptoms: Severe joint pain in my SI joint. This was already inflamed prior to vaccination and i was working with a chiropractor. We were ready to finish treatment but after receiving Dose 1 it flared up and has been very painful.

Healthcare visit (other): Chiropractic

Release 8 — day 7, dose 2

2021-05-30

Systemic reaction (other): The vaccine inflamed my SI joint. I also have very loud, high pitched ringing in my ears that started the day after receiving my second dose and has not gone away.

Release 8 — day 14, dose 2

2021-06-03

Symptoms: My SI joint is still incredibly painful and the ringing in my ears that started after the vaccine has not subsided yet.

Healthcare visit (other): Chiropractor

Release 9 — 3 months, dose 2

2021-08-19

Symptoms: I still have significant tinnitus which was caused by my vaccine. It has not diminished or gone away. I also have severe SI joint pain which i an working with a chiropractor to alleviate.

Healthcare visit (other): Chiropractic

Release 10 — day 7, dose 3

2021-11-29

Systemic reaction (other): I got tinnitus from my 2nd dose. My symptoms had improved slightly but my booster brought me right back to where I was right after receiving my 2nd dose.

Release 11 — 6 months, dose 3

2022-05-21

Symptoms: My tinnitus that resulted from the vaccine is still present. It has not improved.

Release 12 — 12 months, dose 3

2022-11-20

Symptoms: After receiving my bivalent booster my vaccine induced tinnitus is uncomfortably loud and piercing. I have an appointment with an ENT to discuss my symptoms. As a reminder, I got tinnitus within 48 hours after receiving first vaccine dose.

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	Office visit	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Discomfort	·	·	✓
SD	Office visit	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sacral pain	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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