YR5-31514-85975

4 vaccinations 14 coded responses 52 check-ins 13 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 551 / MN
Registered: 2021-03-01

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

2021-03-01
Registered in v-safe
2021-03-01
Dose 1 — Moderna
2021-03-01
Health check-in — day 0, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Joint pains

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Mild sore throat; probably caught my wife's cold.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-08
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-29
Dose 2 — Moderna
2021-03-29
Health check-in — day 0, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Swollen submandibular lymph nodes, both sides.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-05
Survey response — day 7, dose 2
MedDRA: Sinusitis — Feeling: Fair · Headache, Joint pains

Free text: Sinusitis (allergies)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-28
Survey response — 3 months, dose 2
MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: More serious joint pain on a hip.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-27
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good

Free text: Minor congestion, slight sore throat. Some joint pain, but this was associated with intense exertion (mountain hiking).

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Dose 3 — Moderna
2021-10-30
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-06
Survey response — day 7, dose 3
MedDRA: Productive cough — Feeling: Good · Joint pains, Muscle or body aches

Free text: Occasional cough bringing up phlegm.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-20
Survey response — day 21, dose 3
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain in one hip got worse.

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Survey response — day 28, dose 3
MedDRA: Arthralgia, Fall — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Knee pain caused by a fall - not by COVID.

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-30
Call 1 — Left Voicemail
2021-12-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Arthralgia, COVID-19, Cough, Illness, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · 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: Contracted COVID early Jan. -- sore throat, cough, congestion, joint pain during 2-week course of the illness; tested positive for COVID late in the course.

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Cough — Feeling: Good

Free text: Occasional but persistent cough.

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Dose 4 — Moderna
2022-05-16
Survey response — days 1–6 daily, dose 4
MedDRA: Breakthrough COVID-19, Cough — Feeling: Good · Site: Pain

Free text: Mild chronic cough ever since contracting breakthrough COVID in Jan.

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2022-05-21
Health check-in — day 7, dose 4
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2022-05-28
Survey response — day 14, dose 4
MedDRA: Oropharyngeal pain, Rhinalgia — Feeling: Good

Free text: Slight sore throat/soreness in nasal cavity; successfully treated with zinc lozenges.

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-25
Survey response — day 42, dose 4
MedDRA: Dizziness — Feeling: Good

Free text: Some lightheadedness/dizziness while playing golf; may be just a side effect of taking a (low-dose) statin.

MedDRA releases: 2024-11 · check-in free text available
2022-08-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-14
Survey response — 12 months, dose 4
MedDRA: Upper respiratory tract infection — 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

MedDRA releases: 2024-11
2023-05-14
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-15
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-29	Moderna
3	2021-10-30	Moderna	No
4	2022-05-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-28	Successful 2023-05-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-29	Successful 2023-05-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-14	Successful 2023-05-15	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Mild sore throat; probably caught my wife's cold.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Swollen submandibular lymph nodes, both sides.

Release 6 — day 7, dose 2

2021-04-05

Systemic reaction (other): Sinusitis (allergies)

Release 9 — 3 months, dose 2

2021-06-28

Symptoms: More serious joint pain on a hip.

Release 9 — 6 months, dose 2

2021-09-27

Symptoms: Minor congestion, slight sore throat. Some joint pain, but this was associated with intense exertion (mountain hiking).

Release 10 — day 7, dose 3

2021-11-06

Systemic reaction (other): Occasional cough bringing up phlegm.

Release 10 — day 21, dose 3

2021-11-20

Symptoms: Joint pain in one hip got worse.

Release 10 — day 28, dose 3

2021-11-28

Symptoms: Knee pain caused by a fall - not by COVID.

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Contracted COVID early Jan. -- sore throat, cough, congestion, joint pain during 2-week course of the illness; tested positive for COVID late in the course.

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: Occasional but persistent cough.

Release 11 — days 1–6 daily, dose 4

2022-05-16

Systemic reaction (other): Mild chronic cough ever since contracting breakthrough COVID in Jan.

Release 11 — day 14, dose 4

2022-05-28

Symptoms: Slight sore throat/soreness in nasal cavity; successfully treated with zinc lozenges.

Release 12 — day 42, dose 4

2022-06-25

Symptoms: Some lightheadedness/dizziness while playing golf; may be just a side effect of taking a (low-dose) statin.

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	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Fall	·	·	✓
SD	Illness	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinalgia	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Breakthrough COVID-19	·	·	✓
SRO	Cough	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Productive cough	·	·	✓
SRO	Sinusitis	✓	✓	✓

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