YRX-21026-97852

4 vaccinations 7 coded responses 34 check-ins 7 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 221 / VA
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

2021-02-03
Dose 1 — Moderna
2021-02-05
Registered in v-safe
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · 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
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Heart rate increased — Feeling: Good · Site: Pain

Free text: While sleeping last night I felt warm and noted my pulse rate (via Fitbit) was elevated to the high 80s. My rest pulse rate is usually low 60s. It settled down and was OK today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — day 7, dose 2
MedDRA: Fatigue, Myalgia — Feeling: Good

Free text: Yesterday, with the good weather, I decided to do some robust yard work. Resulted in muscle ache and fatigue. Feel great today after more moderate yard work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 14, dose 2
MedDRA: Cough, Laryngitis, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Slight sore throat followed by laryngitis followed by runny nose and dry cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-05
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
Survey response — 3 months, dose 3
MedDRA: Laryngitis — Feeling: Good

Free text: Mild laryngitis

MedDRA releases: 2024-11 · check-in free text available
2022-03-30
Dose 4 — Moderna
2022-04-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-28
Survey response — day 28, dose 4
MedDRA: Aphthous ulcer, Oral herpes — Feeling: Good

Free text: Had a breakout of cold sores on my lips appearing about two days after the 2nd booster. Those have pretty much healed, but did precipitate a canker sore in my tongue, which remains.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — day 42, dose 4
MedDRA: Aphthous ulcer — Feeling: Good

Free text: Canker sore on tongue

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Survey response — 6 months, dose 4
MedDRA: Heart rate increased, Oral herpes, Reaction to previous exposure to any vaccine — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rapid pulse rate while in bed on the night of the injection. Development of cold sore three days after injection. (I developed 4 cold sores over both lips that lingered for a number of weeks after booster #2 this past spring.)

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-04
Call 1 — Could Not Reach Participant
2022-10-07
Call 2 — Left Voicemail
2023-04-01
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-10-26	Moderna	No
4	2022-03-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-30	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): While sleeping last night I felt warm and noted my pulse rate (via Fitbit) was elevated to the high 80s. My rest pulse rate is usually low 60s. It settled down and was OK today.

Release 5 — day 7, dose 2

2021-03-10

Systemic reaction (other): Yesterday, with the good weather, I decided to do some robust yard work. Resulted in muscle ache and fatigue. Feel great today after more moderate yard work.

Release 5 — day 14, dose 2

2021-03-17

Symptoms: Slight sore throat followed by laryngitis followed by runny nose and dry cough.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Mild laryngitis

Release 11 — day 28, dose 4

2022-04-28

Symptoms: Had a breakout of cold sores on my lips appearing about two days after the 2nd booster. Those have pretty much healed, but did precipitate a canker sore in my tongue, which remains.

Release 11 — day 42, dose 4

2022-05-11

Symptoms: Canker sore on tongue

Release 12 — 6 months, dose 4

2022-09-30

Symptoms: Rapid pulse rate while in bed on the night of the injection. Development of cold sore three days after injection. (I developed 4 cold sores over both lips that lingered for a number of weeks after booster #2 this past spring.)

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	Aphthous ulcer	·	·	✓
SD	Cough	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Laryngitis	✓	✓	✓
SD	Oral herpes	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Myalgia	✓	✓	✓

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