YVC-22333-30677

4 vaccinations 11 coded responses 48 check-ins 10 free-text entries 5 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 225 / VA
Registered: 2021-03-04

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

2021-03-02
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Fair · 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: I cannot shake the fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Ear infection, Sinusitis — Feeling: Good · 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: Sinusitis and bilateral ear infection.

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 6 months, dose 2
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)
2021-09-29
Call 1 — Left Voicemail
2021-09-29
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Nausea

Adult check-in
2021-11-02
Survey response — day 7, dose 3
MedDRA: Pain in extremity — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bilateral foot pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — day 14, dose 3
MedDRA: Asthenia, Headache, Malaise, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Since getting the Moderna booster I have been struggling with a general malaise. It comes and goes. I just don't have my usual enthusiasm and energy. I also have headaches and nausea that come and go. No fever or chills. Smell and taste are normal.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 21, dose 3
MedDRA: Plantar fasciitis — Feeling: Good · 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: Plantar facetious in my right foot.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Report sent to call center — day 21, 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)
2021-11-19
Call 1 — Left Voicemail
2021-11-25
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
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinusitis. I get it 3-4 times per year.

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-27
Call successful
Not applicable - Accidental Reporting
2022-01-27
Call successful
Not applicable - Accidental Reporting
2022-01-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-26
Dose 4 — Moderna
2022-04-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-26
Health check-in — day 0, dose 4
Feeling: Good · Fever · None

Adult check-in
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
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 · Nausea

Adult check-in
2022-05-03
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-17
Survey response — day 21, dose 4
MedDRA: Oropharyngeal pain, Paranasal sinus hypersecretion, Plantar fasciitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: 1. Sore throat with heavy mucus sinus drainage. 2. Severe planter CD faceitis.

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Survey response — day 28, dose 4
MedDRA: Cough, Ear discomfort, Headache, Oropharyngeal pain, Paranasal sinus hypersecretion, Pyrexia, Sinus pain, Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever, headache, sinus pain and drainage, ear pressure, sore throat, cough and sneezing.

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-26
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-25
Survey response — 6 months, dose 4
MedDRA: Malaise — Feeling: Poor · Be unable to do your normal daily activities

Free text: I got the second COVID booster on 10/24 and feel really lousy.

MedDRA releases: 2024-11 · check-in free text available
2023-04-26
Survey response — 12 months, dose 4
MedDRA: Ear infection, Injection site pain, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-26
Report sent to call center — 12 months, dose 4
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)
2023-04-27
Call 1 — Left Voicemail
2023-04-27
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-10-26	Moderna	No
4	2022-04-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-13	Successful 2023-04-27	Not applicable - Accidental Reporting
2021-09-28	Successful 2022-01-27	Not applicable - Accidental Reporting
2021-11-18	Successful 2022-01-27	Not applicable - Accidental Reporting
2022-01-26	Successful 2022-01-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-04-26	Unsuccessful

Free text

Release 7 — day 14, dose 2

2021-04-13

Symptoms: I cannot shake the fatigue.

Release 8 — day 35, dose 2

2021-05-04

Symptoms: Fatigue

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: Sinusitis and bilateral ear infection.

Release 10 — day 7, dose 3

2021-11-02

Systemic reaction (other): Bilateral foot pain.

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Since getting the Moderna booster I have been struggling with a general malaise. It comes and goes. I just don't have my usual enthusiasm and energy. I also have headaches and nausea that come and go. No fever or chills. Smell and taste are normal. cut off by CDC

Release 10 — day 21, dose 3

2021-11-18

Symptoms: Plantar facetious in my right foot.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Sinusitis. I get it 3-4 times per year.

Release 11 — day 21, dose 4

2022-05-17

Symptoms: 1. Sore throat with heavy mucus sinus drainage. 2. Severe planter CD faceitis.

Release 11 — day 28, dose 4

2022-05-24

Symptoms: Fever, headache, sinus pain and drainage, ear pressure, sore throat, cough and sneezing.

Release 12 — 6 months, dose 4

2022-10-25

Symptoms: I got the second COVID booster on 10/24 and feel really lousy.

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	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site pain	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Plantar fasciitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sneezing	·	·	✓
SRO	Pain in extremity	·	·	✓

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