ZB9-32730-34971

2 vaccinations 14 coded responses 15 check-ins 14 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 628 / IL
Registered: 2021-06-05

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

2021-05-15
Dose 1 — Moderna
2021-06-05
Registered in v-safe
2021-06-05
Survey response — day 21, dose 1
MedDRA: Dizziness, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Dizziness fever 101.2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-06
Dose 2 — Moderna
2021-06-07
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal distension — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Abdominal sweelig under lower left rib cage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Severe sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-13
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-06-20
Survey response — day 14, dose 2
MedDRA: Abdominal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Abdominal pains under lower ribs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sever pain spikes in left and right upper abdomin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — day 28, dose 2
MedDRA: Abdominal pain lower, Musculoskeletal chest pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Pain in lower R abdominal bad pain in UPPER left abdomin under rib cage.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Survey response — day 35, dose 2
MedDRA: Abdominal pain, Pain of skin — Feeling: Poor · Be unable to do your normal daily activities

Free text: My abdomen hurts from left to right.My skin aross my whole abdomen cant be touched without pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-18
Survey response — day 42, dose 2
MedDRA: Abdominal distension, Abdominal pain lower, Headache, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Headaches,pain swelling of L/R abdomin · Healthcare visit (other): Scheduled CT scans,blood tests

MedDRA releases: 2024-11 · check-in free text available
2021-07-18
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-25
Call 2 — Left Voicemail
2021-09-05
Survey response — 3 months, dose 2
MedDRA: Hepatomegaly, Splenomegaly — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Liver and splee have enlarded

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-05
Survey response — 6 months, dose 2
MedDRA: Hepatomegaly, Splenomegaly — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Liver and splee enlarged

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
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

Emergency room or emergency department visit · 1 call case(s)
2021-12-06
Call 2 — Left Voicemail
2022-06-08
Survey response — 12 months, dose 2
MedDRA: Arterial disorder — 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 · Hospitalization

Free text: Arterial degenerations

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Report sent to call center — 12 months, 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

Hospitalization · 1 call case(s)
2022-06-09
Call 1 — Left Voicemail
2022-06-09
Call 1 — Left Voicemail
2022-06-09
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-15	Moderna
2	2021-06-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-07-18	Unsuccessful
2021-12-05	Unsuccessful
2022-06-08	Unsuccessful

Free text

Release 8 — day 21, dose 1

2021-06-05

Symptoms: Dizziness fever 101.2

Release 8 — days 1–6 daily, dose 2

2021-06-07

Systemic reaction (other): None

Release 9 — days 1–6 daily, dose 2

2021-06-09

Systemic reaction (other): Abdominal sweelig under lower left rib cage

2021-06-10

Systemic reaction (other): Severe sweating

2021-06-11

Systemic reaction (other): Sweating

2021-06-12

Systemic reaction (other): None

Release 9 — day 14, dose 2

2021-06-20

Symptoms: Abdominal pains under lower ribs

Release 9 — day 21, dose 2

2021-06-27

Symptoms: Sever pain spikes in left and right upper abdomin

Release 9 — day 28, dose 2

2021-07-06

Symptoms: Pain in lower R abdominal bad pain in UPPER left abdomin under rib cage.

Release 9 — day 35, dose 2

2021-07-11

Symptoms: My abdomen hurts from left to right.My skin aross my whole abdomen cant be touched without pain.

Release 9 — day 42, dose 2

2021-07-18

Symptoms: Headaches,pain swelling of L/R abdomin

Healthcare visit (other): Scheduled CT scans,blood tests

Release 9 — 3 months, dose 2

2021-09-05

Symptoms: Liver and splee have enlarded

Release 10 — 6 months, dose 2

2021-12-05

Symptoms: Liver and splee enlarged

Release 11 — 12 months, dose 2

2022-06-08

Symptoms: Arterial degenerations

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	Unevaluable event	·	·	✓
SD	Abdominal distension	·	·	✓
SD	Abdominal pain	✓	✓	✓
SD	Abdominal pain lower	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arterial disorder	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Headache	·	·	✓
SD	Hepatomegaly	✓	·	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Pain of skin	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Splenomegaly	✓	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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