Z7S-30932-95468

4 vaccinations 9 coded responses 45 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 980 / WA
Registered: 2021-04-15

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

PEB-96873-28861 Child or adolescent in my care · Male · 2022-06-27

Timeline

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

2021-04-15
Registered in v-safe
2021-04-15
Dose 1 — Moderna
2021-04-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-27
Survey response — day 14, dose 2
MedDRA: Cardiac flutter, Condition aggravated, Heart rate increased, Pre-existing disease — Feeling: Fair

Free text: My heart does an occasional flutter thing, especially when my heart rate suddenly increases; used to happen maybe once/2mos, now is pretty frequent

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-02
Dose 3 — Moderna
2021-12-02
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fever · Muscle or body aches

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Nausea

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-12-06
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Fatigue is likely due to late night child care

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: Also new dad

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — day 7, dose 3
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: New dad

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-13
Survey response — day 42, dose 3
MedDRA: Rhinorrhoea — Feeling: Good

Free text: I've had a slightly runny nose the last five days

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-02
Survey response — 6 months, dose 3
MedDRA: Chest discomfort, Fatigue — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: For the past few weeks, I get tired suddenly with some feeling of fullness in my chest. I have not yet scheduled a doctor appointment to figure out why.

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-03
Call 1 — Left Voicemail
2022-09-12
Dose 4 — Pfizer-BioNTech
2022-09-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-18
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Long day of moving plus late night pet much explains it

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-26
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-10-24
Survey response — day 42, dose 4
MedDRA: Cough, Pyrexia, Rhinorrhoea — Feeling: Fair

Free text: Runny nose, mild cough, low fever

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-13
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna
3	2021-12-02	Moderna	No
4	2022-09-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-02	Unsuccessful

Free text

Release 8 — day 14, dose 2

2021-05-27

Symptoms: My heart does an occasional flutter thing, especially when my heart rate suddenly increases; used to happen maybe once/2mos, now is pretty frequent

Release 10 — days 1–6 daily, dose 3

2021-12-06

Systemic reaction (other): Fatigue is likely due to late night child care

2021-12-08

Systemic reaction (other): Also new dad

Release 10 — day 7, dose 3

2021-12-09

Systemic reaction (other): New dad

Release 10 — day 42, dose 3

2022-01-13

Symptoms: I've had a slightly runny nose the last five days

Release 11 — 6 months, dose 3

2022-06-02

Symptoms: For the past few weeks, I get tired suddenly with some feeling of fullness in my chest. I have not yet scheduled a doctor appointment to figure out why.

Release 12 — days 1–6 daily, dose 4

2022-09-18

Systemic reaction (other): Long day of moving plus late night pet much explains it

Release 12 — day 42, dose 4

2022-10-24

Symptoms: Runny nose, mild cough, low fever

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	Cardiac flutter	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Unevaluable event	·	·	✓

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