YRY-34020-24834

3 vaccinations 9 coded responses 19 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 920 / CA
Registered: 2021-04-27

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-03-27
Dose 1 — Moderna
2021-04-27
Registered in v-safe
2021-04-27
Dose 2 — Moderna
2021-04-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Itching · None

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Some lightheadedness at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Pruritus — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Some general itching and bouts of lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Occasional itching on my body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature normal, Hyperhidrosis — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Sweating early this morning for no apparent reason, took temperature but was in normal range

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Supraventricular extrasystoles — Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: PACs intermittent throughout the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased, Heart rate decreased — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Having some low HR and higher than normal BP and possibly PACs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 7, dose 2
MedDRA: Body temperature increased, Hyperhidrosis, Hypertension, Insomnia, Night sweats — Feeling: Good · Fatigue or tiredness

Free text: Multiple PACs higher BP last night, trouble falling asleep, excessive sweating during night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 14, dose 2
MedDRA: Night sweats, Vomiting — Feeling: Fair

Free text: Last week started having PACs, particularly severe attack one evening, finally fell asleep and later woke up in a sweat, but felt better, had a few other occasions of sweating and PACs. I Contacted my (b)(6) cardiologist and reported the episodes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-26
Dose 3 — Pfizer-BioNTech
2022-04-29
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-28
Survey response — 12 months, dose 3
MedDRA: Atrial fibrillation, Supraventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-01-28
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-01-30
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-27	Moderna
3	2022-01-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2023-01-28	Successful 2023-01-30	Completed over the phone

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Some lightheadedness at times

2021-04-29

Systemic reaction (other): Some general itching and bouts of lightheadedness

2021-04-30

Systemic reaction (other): Occasional itching on my body

2021-05-01

Systemic reaction (other): Sweating early this morning for no apparent reason, took temperature but was in normal range

2021-05-02

Systemic reaction (other): PACs intermittent throughout the day

2021-05-03

Systemic reaction (other): Having some low HR and higher than normal BP and possibly PACs

Release 8 — day 7, dose 2

2021-05-04

Systemic reaction (other): Multiple PACs higher BP last night, trouble falling asleep, excessive sweating during night.

Release 8 — day 14, dose 2

2021-05-11

Symptoms: Last week started having PACs, particularly severe attack one evening, finally fell asleep and later woke up in a sweat, but felt better, had a few other occasions of sweating and PACs. I Contacted my (b)(6) cardiologist and reported the episodes.

redacted (b)(6)

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	Atrial fibrillation	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Supraventricular extrasystoles	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Body temperature normal	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate decreased	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Supraventricular extrasystoles	✓	✓	✓

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