YRU-18026-78355

5 vaccinations 5 coded responses 37 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 385 / TN
Registered: 2021-02-25

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

2021-02-22
Dose 1 — Moderna
2021-02-25
Registered in v-safe
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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 — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-22
Dose 2 — Moderna
2021-03-22
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

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 — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 28, dose 2
MedDRA: Corneal erosion, Dry eye, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My right eye had an erosion of the cornea incident. This was caused because of my eye being dry. I have made 3 visits to my eye doctor since last Friday I lost my left eye due to an accident years ago so its an important issue to me. · Healthcare visit (other): Visit to eye doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-21
Survey response — 3 months, dose 2
MedDRA: Ear pain — Feeling: Fair

Free text: I have had an earache for the past two days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Dose 3 — Moderna
2022-03-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-24
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-25
Dose 4 — Moderna
2022-04-29
Survey response — days 1–6 daily, dose 4
MedDRA: Pain in extremity — Feeling: Good

Free text: My arm was very sore the first 36 hours. All good now

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-05-02
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-06
Survey response — day 42, dose 4
MedDRA: Chills, Fatigue, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tired 2 days in a row. Chills overnight. Ringing in my ears.

MedDRA releases: 2024-11 · check-in free text available
2022-07-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-09
Dose 5 — Moderna
2022-09-28
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-09-30
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-10
Survey response — 3 months, dose 5
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Last week I had a cold. Much better now

MedDRA releases: 2024-11 · check-in free text available
2023-03-10
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-22	Moderna
2	2021-03-22	Moderna
3	2021-11-11	Moderna	No
4	2022-04-25	Moderna	No
5	2022-09-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-21	Successful 2022-03-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7 — day 28, dose 2

2021-04-21

Symptoms: My right eye had an erosion of the cornea incident. This was caused because of my eye being dry. I have made 3 visits to my eye doctor since last Friday I lost my left eye due to an accident years ago so its an important issue to me.

Healthcare visit (other): Visit to eye doctor

Release 9 — 3 months, dose 2

2021-06-21

Symptoms: I have had an earache for the past two days

Release 11 — days 1–6 daily, dose 4

2022-04-29

Systemic reaction (other): My arm was very sore the first 36 hours. All good now

Release 11 — day 42, dose 4

2022-06-06

Symptoms: Very tired 2 days in a row. Chills overnight. Ringing in my ears.

Release 12 — 3 months, dose 5

2022-12-10

Symptoms: Last week I had a cold. Much better now

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	Chills	·	·	✓
SD	Corneal erosion	✓	✓	✓
SD	Dry eye	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tinnitus	·	·	✓
SRO	Pain in extremity	·	·	✓

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