YRX-16310-88444

5 vaccinations 16 coded responses 47 check-ins 16 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 030 / NH
Registered: 2021-02-05

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

2021-02-04
Dose 1 — Moderna
2021-02-05
Registered in v-safe
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Hot flush, Pre-existing disease — Feeling: Good

Free text: Hot flashes like when I had hormonal treatments for prostate cancer. Nothing serious.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 28, dose 1
MedDRA: Fatigue, Hot flush, Injection site pain — Feeling: Good

Free text: Return of hot flashes and a bit more fatigue.Also, experiencing slight pain at injection site that had not appeared until this week.The symptoms are mild. If I wasn't asked, I would not have mentioned them.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 35, dose 1
MedDRA: Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Lower tract with mild nausea for past week.Cause unknown.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-05-06
Survey response — 3 months, dose 1
MedDRA: Anal incontinence, Diarrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Extreme diarrhea for 4 days. Bowel movements were clear, better than my colonoscopy preps. First time I had to change my bedding due bowel leakage since the time I was in diapers.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-05
Survey response — 6 months, dose 1
MedDRA: Condition aggravated, Dizziness, Headache, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headaches and light headed more frequently. This may be from a change in prescription meds. This may also be from a flair up of my neurosarcoidosis. Actively being followed by my neurologist.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: severe headaches probably due to my neurosarcodoisis

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Oral surgery — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea

Free text: Recent oral surgery, possible CFS leak

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Oral surgery — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: recent oral surgery

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Oral surgery — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Oral surgery

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — day 7, dose 3
MedDRA: Oral surgery — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Oral surgery

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-02
Dose 4 — Moderna
2022-04-03
Survey response — days 1–6 daily, dose 4
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: I reaction was stronger than the previous shots.

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2022-04-05
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Had colonoscopy on March 31, 2022

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-04-07
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Good

Free text: colonoscopy on March 31, constipation over last several months

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-09
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-16
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-23
Survey response — day 21, dose 4
MedDRA: Influenza like illness, Nasopharyngitis, Oropharyngeal pain, Throat irritation, Upper-airway cough syndrome — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cold/flu-like symptoms sore throat, lots of post nasal drip irritation two antigen tests (Monday and Thursday) were negative

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Survey response — day 28, dose 4
MedDRA: Dyspnoea, Fatigue, Sinusitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus infections, short of breath, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-01
Survey response — 6 months, dose 4
MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test positive — Feeling: Good

Free text: Exposure to Covid twice. No symptoms July 19 PCR tested positive on July 24. No symptoms for last week's exposure. PCR test taken yesterday awaiting results.

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Dose 5 — Moderna
2022-11-16
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-21
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-05
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-12
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-01
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-01
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-25	Moderna	No
3	2021-10-26	Moderna	No
4	2022-04-02	Moderna	No
5	2022-10-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-06	Unsuccessful
2021-08-05	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Hot flashes like when I had hormonal treatments for prostate cancer. Nothing serious.

Release 5 — day 28, dose 1

2021-03-04

Symptoms: Return of hot flashes and a bit more fatigue.Also, experiencing slight pain at injection site that had not appeared until this week.The symptoms are mild. If I wasn't asked, I would not have mentioned them.

Release 5 — day 35, dose 1

2021-03-11

Symptoms: Lower tract with mild nausea for past week.Cause unknown.

Release 8 — 3 months, dose 1

2021-05-06

Symptoms: Extreme diarrhea for 4 days. Bowel movements were clear, better than my colonoscopy preps. First time I had to change my bedding due bowel leakage since the time I was in diapers.

Release 9 — 6 months, dose 1

2021-08-05

Symptoms: Headaches and light headed more frequently. This may be from a change in prescription meds. This may also be from a flair up of my neurosarcoidosis. Actively being followed by my neurologist.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: severe headaches probably due to my neurosarcodoisis

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Recent oral surgery, possible CFS leak

2021-10-31

Systemic reaction (other): recent oral surgery

2021-11-01

Systemic reaction (other): Oral surgery

Release 10 — day 7, dose 3

2021-11-02

Systemic reaction (other): Oral surgery

Release 11 — days 1–6 daily, dose 4

2022-04-03

Systemic reaction (other): I reaction was stronger than the previous shots.

2022-04-05

Systemic reaction (other): Had colonoscopy on March 31, 2022

2022-04-07

Systemic reaction (other): colonoscopy on March 31, constipation over last several months

Release 11 — day 21, dose 4

2022-04-23

Symptoms: Cold/flu-like symptoms sore throat, lots of post nasal drip irritation two antigen tests (Monday and Thursday) were negative

Release 11 — day 28, dose 4

2022-04-30

Symptoms: Sinus infections, short of breath, fatigue

Release 12 — 6 months, dose 4

2022-10-01

Symptoms: Exposure to Covid twice. No symptoms July 19 PCR tested positive on July 24. No symptoms for last week's exposure. PCR test taken yesterday awaiting results.

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	Anal incontinence	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Dyspnoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	·	✓
SD	Hot flush	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinusitis	·	·	✓
SD	Throat irritation	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Constipation	·	·	✓
SRO	Oral surgery	·	·	✓
SRO	Unevaluable event	·	·	✓

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