Z6M-18714-23567

4 vaccinations 10 coded responses 52 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-03-02

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
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

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

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

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

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-08
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
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal sleep-related event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My CPAP reported many more events when I was sleeping.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Urinary tract infection — Feeling: Fair

Free text: Have a UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 28, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Fatigue is much worse. I hit a brick wall everyday around 5

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Fatigue, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue, low grade fever, shortness of breath,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-27
Dose 3 — Moderna
2021-10-27
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — day 7, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 28, dose 3
MedDRA: Fatigue, Headache — Feeling: Fair

Free text: Having headach and real tired

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Survey response — day 42, dose 3
MedDRA: Fatigue, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school

Free text: Congestion and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-27
Dose 4 — Moderna
2022-04-27
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-04
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-18
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-27
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-06-09
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-27
Survey response — 3 months, dose 4
MedDRA: Fatigue, Headache, Pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme fatigue, headaches and body aches.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Survey response — 6 months, dose 4
MedDRA: Fatigue, Malaise, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: After the new booster I was very fatigued, had a fever, and generally did not feel well for a few weeks. I had my flu shot the week before.

MedDRA releases: 2024-11 · check-in free text available
2023-04-27
Survey response — 12 months, dose 4
MedDRA: Balance disorder, Brain fog, Dizziness, Fatigue — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-04-27
Report sent to call center — 12 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

Emergency room or emergency department visit · 1 call case(s)
2023-04-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-31	Moderna
3	2021-10-27	Moderna	No
4	2022-04-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-04-27	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): My CPAP reported many more events when I was sleeping.

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Have a UTI

Release 8 — day 28, dose 2

2021-04-28

Symptoms: Fatigue is much worse. I hit a brick wall everyday around 5

Release 9 — 3 months, dose 2

2021-06-30

Symptoms: Fatigue, low grade fever, shortness of breath,

Release 10 — day 28, dose 3

2021-11-26

Symptoms: Having headach and real tired

Release 10 — day 42, dose 3

2021-12-10

Symptoms: Congestion and fatigue

Release 11 — day 28, dose 4

2022-05-27

Symptoms: Fatigue

Release 12 — 3 months, dose 4

2022-07-27

Symptoms: Extreme fatigue, headaches and body aches.

Release 12 — 6 months, dose 4

2022-10-26

Symptoms: After the new booster I was very fatigued, had a fever, and generally did not feel well for a few weeks. I had my flu shot the week before.

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	Balance disorder	·	·	✓
SD	Brain fog	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Abnormal sleep-related event	✓	✓	✓

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