YLN-33634-01964

4 vaccinations 9 coded responses 53 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 086 / NJ
Registered: 2021-02-24

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

2021-02-24
Registered in v-safe
2021-02-24
Dose 1 — Moderna
2021-02-24
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Very slight light headed feeling earlier today that's been resolved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

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

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

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-03-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-24
Dose 2 — Moderna
2021-03-24
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis, Immediate post-injection reaction — 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: I was sweating excessively yesterday about 1 hour after I received the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 21, dose 2
MedDRA: Headache, Oropharyngeal pain, Pre-existing disease, Sinus disorder — Feeling: Fair

Free text: Have had a headache and sore throat. Pretty sure it's my sinuses and hopefully I'll be better soon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 35, dose 2
Feeling: Fair

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

Adult check-in
2021-06-23
Survey response — 3 months, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-22
Survey response — 6 months, dose 2
MedDRA: Cough, Headache, Oropharyngeal pain, Pain — Feeling: Good

Free text: Sore throat, headaches and body aches.Nothing too severe though. Some coughing also.

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Fair

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
Survey response — day 42, dose 3
MedDRA: Cough, Diarrhoea — Feeling: Fair

Free text: Diarrhea and a cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Cough, Headache, Pain — Feeling: Fair · Be unable to work or attend school

Free text: Headaches, body aches, cough

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-22
Dose 4 — Moderna
2022-10-22
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-10-29
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-27
Survey response — day 35, dose 4
MedDRA: Headache, Migraine — Feeling: Poor · Be unable to do your normal daily activities

Free text: Bad headaches..migraines

MedDRA releases: 2024-11 · check-in free text available
2022-12-03
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-21
Survey response — 3 months, dose 4
MedDRA: Arrhythmia, Fatigue, Headache, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2024-11
2023-01-21
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2023-01-23
Call 1 — Left Voicemail
2023-04-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-24	Moderna
3	2021-10-26	Moderna	No
4	2022-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-01-21	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-24

Systemic reaction (other): Very slight light headed feeling earlier today that's been resolved.

Release 6 — days 1–6 daily, dose 2

2021-03-25

Systemic reaction (other): I was sweating excessively yesterday about 1 hour after I received the vaccine.

Release 7 — day 21, dose 2

2021-04-14

Symptoms: Have had a headache and sore throat. Pretty sure it's my sinuses and hopefully I'll be better soon

Release 9 — 3 months, dose 2

2021-06-23

Symptoms: Headaches

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: Sore throat, headaches and body aches.Nothing too severe though. Some coughing also.

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Diarrhea and a cough

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Headaches, body aches, cough

Release 12 — day 35, dose 4

2022-11-27

Symptoms: Bad headaches..migraines

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	Arrhythmia	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Migraine	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓

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