YMQ-15085-20192

4 vaccinations 5 coded responses 26 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 076 / NJ
Registered: 2021-02-27

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-02-26
Dose 1 — Moderna
2021-02-27
Registered in v-safe
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Fair

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

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Runny nose; congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Fatigue, Illness, Malaise, Nasopharyngitis, Oral herpes — 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: Got sick, extremely fatigued and developed a fever blister, which is usually my ultimate indication of a cold; however I dont believe its covid or vaccine-related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Diarrhea

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-05-05
Call 1 — Left Voicemail
2022-09-09
Dose 4 — Moderna
2022-09-12
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Immediate post-injection reaction, Palpitations — Feeling: Fair

Free text: Immediately upon receiving the shot, I felt my heart racing and I got very fatigued while sitting in the CVS waiting area. My heart was racing for a few hours, and it's seemed to have gone away, but I wanted to report this.

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-09-25
Survey response — day 14, dose 4
MedDRA: Fatigue, Headache, Hyperhidrosis, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sweating, fatigue, scratchy throat, headache

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — day 21, dose 4
MedDRA: Chills, Exposure to SARS-CoV-2, Fatigue, Hyperhidrosis, Malaise, Pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: I had close contact with my sister this past Saturday and the next day she tested positive for COVID. That same day, I began to feel sick: sweats, body aches, chills, fatigue, which lasted several days. However I tested negative each of those days.

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-10-23	Moderna	No
4	2022-09-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-07	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Runny nose; congestion

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Got sick, extremely fatigued and developed a fever blister, which is usually my ultimate indication of a cold; however I dont believe its covid or vaccine-related

Release 12 — days 1–6 daily, dose 4

2022-09-12

Systemic reaction (other): Immediately upon receiving the shot, I felt my heart racing and I got very fatigued while sitting in the CVS waiting area. My heart was racing for a few hours, and it's seemed to have gone away, but I wanted to report this.

Release 12 — day 14, dose 4

2022-09-25

Symptoms: Sweating, fatigue, scratchy throat, headache

Release 12 — day 21, dose 4

2022-09-30

Symptoms: I had close contact with my sister this past Saturday and the next day she tested positive for COVID. That same day, I began to feel sick: sweats, body aches, chills, fatigue, which lasted several days. However I tested negative each of those days. cut off by CDC

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	Chills	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Illness	✓	✓	○
SD	Malaise	·	·	✓
SD	Nasopharyngitis	✓	✓	○
SD	Oral herpes	✓	✓	✓
SD	Pain	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Palpitations	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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