YTK-41229-62241

5 vaccinations 19 coded responses 48 check-ins 18 free-text entries 7 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 339 / FL
Registered: 2021-04-18

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

2021-04-14
Dose 1 — Moderna
2021-04-18
Registered in v-safe
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Runny nosr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 21, dose 1
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

Free text: Sore throat, runny nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Dose 2 — Moderna
2021-05-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, hard to breathe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tremor — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, trembling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Started steroids back therapy today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Suddenly my knees hurt!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-10
Survey response — day 28, dose 2
MedDRA: Dizziness, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Suddenly very fatigued, slightly dizzy for no apparent reason.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Continued headaches, fatigue, stomach pain · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — day 35, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-23
Call 2 — Left Voicemail
2021-06-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-13
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe cold symptoms started yesterday. Probably environmental allergies.

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

Adult check-in
2021-11-15
Dose 3 — Moderna
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-11-20
Report sent to call center — days 1–6 daily, 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)
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Office visit — Feeling: Poor · Site: Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Dr. Visit

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Hospitalization · 1 call case(s)
2021-11-22
Health check-in — day 7, dose 3
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-11-22
Report sent to call center — day 7, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-22
Call 3 — Left Voicemail
2021-11-22
Call 3 — Left Voicemail
2021-12-01
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Survey response — day 21, dose 3
MedDRA: Feeling abnormal, Salmonellosis, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Not related to booster. Salmonella on Thanksgiving. Still feeling bad. · Healthcare visit (other): Next day doctor appointment

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-12-09
Call 3 — Left Voicemail
2021-12-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-11
Dose 4 — Moderna
2022-05-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-05-27
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-01
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-08
Survey response — day 28, dose 4
MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat stuffy nose

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Survey response — day 35, dose 4
MedDRA: Fatigue, Headache, Nausea, Restlessness, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sick to my stomach, runny nose, headache. Fatigued, restlessness.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-10
Survey response — 3 months, dose 4
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend school, 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: Head cold

MedDRA releases: 2024-11 · check-in free text available
2022-08-10
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-11
Call 3 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-10-07
Dose 5 — Moderna
2022-10-24
Survey response — day 14, dose 5
MedDRA: Peripheral swelling — Feeling: Fair

Free text: Very swollen arm

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-04
Survey response — day 28, dose 5
MedDRA: Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sneezing like crazy. Allergies?

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-18
Survey response — day 42, dose 5
MedDRA: Cough, Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sneezing, coughing. Cold?

MedDRA releases: 2024-11 · check-in free text available
2023-01-06
Survey response — 3 months, dose 5
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to work or attend school, 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
2023-01-06
Report sent to call center — 3 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-04-09
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna
3	2021-11-15	Moderna	No
4	2022-05-11	Moderna	No
5	2022-10-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-16	Unsuccessful
2021-11-20	Unsuccessful
2021-11-21	Unsuccessful
2021-11-22	Unsuccessful
2021-12-07	Unsuccessful
2022-08-10	Unsuccessful
2023-01-06	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): Dizziness

2021-04-19

Systemic reaction (other): Runny nosr

Release 8 — day 21, dose 1

2021-05-05

Symptoms: Sore throat, runny nose.

Release 8 — days 1–6 daily, dose 2

2021-05-13

Systemic reaction (other): Sore throat, hard to breathe.

2021-05-14

Systemic reaction (other): Dizzy, trembling

2021-05-15

Systemic reaction (other): Started steroids back therapy today

2021-05-18

Systemic reaction (other): Suddenly my knees hurt!

Release 9 — day 28, dose 2

2021-06-10

Symptoms: Suddenly very fatigued, slightly dizzy for no apparent reason.

Release 9 — day 35, dose 2

2021-06-16

Symptoms: Continued headaches, fatigue, stomach pain

Healthcare visit (other): Office visit

Release 9 — 3 months, dose 2

2021-08-13

Symptoms: Severe cold symptoms started yesterday. Probably environmental allergies.

Release 10 — days 1–6 daily, dose 3

2021-11-21

Healthcare visit (other): Dr. Visit

Release 10 — day 21, dose 3

2021-12-07

Symptoms: Not related to booster. Salmonella on Thanksgiving. Still feeling bad.

Healthcare visit (other): Next day doctor appointment

Release 11 — day 28, dose 4

2022-06-08

Symptoms: Sore throat stuffy nose

Release 12 — day 35, dose 4

2022-06-15

Symptoms: Sick to my stomach, runny nose, headache. Fatigued, restlessness.

Release 12 — 3 months, dose 4

2022-08-10

Symptoms: Head cold

Release 12 — day 14, dose 5

2022-10-24

Symptoms: Very swollen arm

Release 12 — day 28, dose 5

2022-11-04

Symptoms: Sneezing like crazy. Allergies?

Release 12 — day 42, dose 5

2022-11-18

Symptoms: Sneezing, coughing. Cold?

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	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	✓	·	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	✓	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Peripheral swelling	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Restlessness	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Salmonellosis	·	·	✓
SD	Sneezing	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Tremor	✓	✓	✓

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