YPK-13909-59239

4 vaccinations 22 coded responses 49 check-ins 21 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 191 / PA
Registered: 2021-01-21

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

XV6-22862-85335 Child or adolescent in my care · Male · 2022-07-24

Timeline

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Abnormal dreams — Feeling: Good · Site: Pain · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Abnormal dreams, Injection site pain — Feeling: Good · Site: Pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Myalgia, Pain — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pain, Sleep disorder — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-28
Survey response — 7 day, dose 1
MedDRA: Dizziness — Feeling: Good · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-04
Survey response — 14 day, dose 1
MedDRA: Abnormal faeces, Diarrhoea, Stress — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-12
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — 28 day, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Impaired work ability — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Impaired work ability — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Poor quality sleep — Feeling: Good · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Impaired work ability — Feeling: Fair · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-04
Survey response — 7 day, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-11
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — 21 day, dose 2
MedDRA: Fatigue, Impaired work ability, Sleep disorder, Stress — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-25
Health check-in — 28 day, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-11-23
Dose 3 — Moderna
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Injection site pain, Nausea — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-11-29
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction, Insomnia, Pain in extremity, Stress — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-11-30
Survey response — 7 day, dose 3
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness, Nausea

MedDRA releases: 2024-11 · check-in answers available
2021-12-07
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-12-15
Survey response — 21 day, dose 3
MedDRA: Headache, Hypersensitivity, Nasopharyngitis, Pre-existing disease, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-12-21
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2021-12-28
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2022-01-04
Survey response — 42 day, dose 3
MedDRA: Fatigue, Poor quality sleep — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-02-22
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-05-24
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-09-10
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-10
Health check-in — 0 day, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-09-17
Health check-in — 7 day, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-10-03
Survey response — 21 day, dose 4
MedDRA: Pre-existing disease, Respiratory tract congestion — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-10-08
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-10-16
Survey response — 35 day, dose 4
MedDRA: Headache — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-10-22
Survey response — 42 day, dose 4
MedDRA: Chills, Oropharyngeal pain, Pain, Pharyngitis, Pyrexia, Streptococcal infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-10-22
Report sent to call center — 42 day, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call 1 — Left Voicemail
2022-12-10
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2023-03-11
Survey response — 6 month, dose 4
MedDRA: Ear infection, Upper respiratory tract infection — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-25	Moderna
3	2021-11-23	Moderna	No
4	2022-09-10	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-10-22	Unsuccessful

Free text

Release 2

Systemic reaction (other): Vivid dreams

Systemic reaction (other): Note: vivid dreams resolved, but I had them on first two nights. Injection site pain fully resolved by midday.

Systemic reaction (other): Muscle or body aches -- I exerted myself physically yesterday, and feel like my mild aches are consistent with my activities. Perhaps very slightly worse than I anticipated feeling today.

Systemic reaction (other): Very mild fatigue and aches, likely attributable to interrupted sleep and strenuous activities on Sunday

Systemic reaction (other): Mild lightheadness, likely related to drinking and eating less this morning

Release 3

Symptoms: Looser and more frequent stool. No discomfort or disruption. Likely from slight dietary changes and stress, but notable.

Release 4

Systemic reaction (other): I'm marking none on the next screen -- the symptoms have decreased my work productivity considerably but not enough to make me unable to work at all.

Systemic reaction (other): Reduced efficacy with work

Systemic reaction (other): Likely relates to poor sleep based on working late. Decreased work efficacy today.

Systemic reaction (other): Continued decreased efficacy from above, likely related to other stressors

Systemic reaction (other): Reduced work efficacy

Release 5

Systemic reaction (other): Loose stool, likely related to diet and stress.

Symptoms: Worsening fatigue. Likely explainable by stress and disrupted sleep. Diminished efficacy, but no interrupted work.

Release 10

Systemic reaction (other): On 11/23 and 11/24 I experienced mild pain at injection site, mild nausea, and mild fatigue

Systemic reaction (other): All reported things likely from overextertion yesterday, stress, and lack of sleep. Arm particularly sore.

Systemic reaction (other): Both feel related to stress & altered sleep/eat schedule from taking care of newborn

Symptoms: I've had some worsening allergies / cold-like symptoms (headache, congestion). No known COVID exposures & very limited contact with anyone. Negative rapid test.

Symptoms: Fatigue that seems related to poor sleep hygiene (unrelated to vaccine)

Release 12

Symptoms: Congestion consistent with lifelong seasonal allergies

Symptoms: Mild headache today and several other days

Symptoms: Strep (Group G), pharyngitis - fever, chills, aches, sore throat for 3.5 days

Free-text releases are not linked to a specific 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	Abnormal faeces	✓	✓	✓
SD	Chills	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Impaired work ability	✓	✓	○
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pharyngitis	·	·	✓
SD	Poor quality sleep	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Streptococcal infection	·	·	✓
SD	Stress	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Stress	·	·	✓
SRO	Unevaluable event	·	·	✓

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