YM3-27292-60453

2 vaccinations 5 coded responses 22 check-ins 5 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 130 / NY
Registered: 2021-02-20

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

2021-02-17
Dose 1 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Muscle or body aches

Free text: Sore from shoveling snow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-03
Survey response — day 14, dose 1
MedDRA: Atrial flutter, Medical counselling, Ventricular extrasystoles — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sunday and Monday I experienced large number of PVCs or PACs. Yesterday morning I went into Atrial Flutter and underwent electro cardioversion this afternoon. This probably was a result of mitral valve repair last December. · Healthcare visit (other): Trip to cardiologist, followed by outpatient care at hospital for the procedure.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 21, dose 1
MedDRA: Atrial flutter, Cardioversion, Electrocardiogram abnormal, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Atrial flutter on Wed 3rd that required electro cardioversion · Healthcare visit (other): Out patient procedure at hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
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)
2021-03-17
Dose 2 — Moderna
2021-03-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Abdominal pain

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-31
Survey response — day 14, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat comes and goes

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

Adult check-in
2021-04-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-16
Survey response — 3 months, dose 2
MedDRA: Asthenia, Dyspnoea, Specialist consultation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Experiencing shortness of breath and weakness when doing things that require more effort e.g. walking up one flight of stairs at home, bringing garbage cans in from the curb, taking a walk. These symtoms are not consistent. Started about 6 weeks ago. · Healthcare visit (other): Cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call 1 — Left Voicemail
2021-06-29
Call successful
Participant prefers to complete VAERS report online
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-17
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-03	Successful	Participant prefers to complete VAERS report online
2021-03-10	Successful	Participant prefers to complete VAERS report online
2021-06-16	Successful 2021-06-29	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): Sore from shoveling snow

Release 5 — day 14, dose 1

2021-03-03

Symptoms: Sunday and Monday I experienced large number of PVCs or PACs. Yesterday morning I went into Atrial Flutter and underwent electro cardioversion this afternoon. This probably was a result of mitral valve repair last December.

Healthcare visit (other): Trip to cardiologist, followed by outpatient care at hospital for the procedure.

Release 5 — day 21, dose 1

2021-03-10

Symptoms: Atrial flutter on Wed 3rd that required electro cardioversion

Healthcare visit (other): Out patient procedure at hospital

Release 6 — day 14, dose 2

2021-03-31

Symptoms: Sore throat comes and goes

Release 9 — 3 months, dose 2

2021-06-16

Symptoms: Experiencing shortness of breath and weakness when doing things that require more effort e.g. walking up one flight of stairs at home, bringing garbage cans in from the curb, taking a walk. These symtoms are not consistent. Started about 6 weeks ago. cut off by CDC

Healthcare visit (other): Cardiologist

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Atrial flutter	✓	✓	✓
SD	Cardioversion	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Electrocardiogram abnormal	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Ventricular extrasystoles	✓	✓	✓
SRO	Pain	✓	✓	✓

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