ZBN-20970-76200

5 vaccinations 10 coded responses 56 check-ins 10 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 485 / MI
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Survey response — day 0, dose 1
MedDRA: Fatigue, Ocular hyperaemia — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: No real reaction, I felt tired and my eyes got red, which is rare. Thats it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Hot flush — Feeling: Good · Fever

Free text: Feeling Flushed and hot. Nothing serious.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: Nope

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Emergency care, Pleurisy — Feeling: Poor · Vomiting · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I had to go to the ER and I have pleurisy it may be unrelated but its a hell of a good time Ill tell you that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 7, dose 1
MedDRA: Pleurisy — Feeling: Poor · Fever · Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Pleurisy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: I feel fantastic! Thanks!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Call 1 — Left Voicemail
2021-11-01
Dose 3 — Moderna
2021-11-01
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-12
Dose 4 — Moderna
2022-04-19
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-12-13
Dose 5 — Moderna
2022-12-13
Survey response — day 0, dose 5
MedDRA: Reaction to previous exposure to any vaccine — Feeling: Good

Free text: It's early. I get a very uncomfortable reaction overnight following all of these shots so far. Onset of problems after eight hours or so.

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-18
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-12-23
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-12-28
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-01-03
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-01-10
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2023-01-17
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-01-24
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-14
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-06-13
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna
3	2021-11-01	Moderna	No
4	2022-04-12	Moderna	No
5	2022-12-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-17

Systemic reaction (other): No real reaction, I felt tired and my eyes got red, which is rare. Thats it.

Release 6 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Feeling Flushed and hot. Nothing serious.

2021-03-22

Systemic reaction (other): Nope

2021-03-23

Systemic reaction (other): I had to go to the ER and I have pleurisy it may be unrelated but its a hell of a good time Ill tell you that.

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Pleurisy

Release 7 — day 0, dose 2

2021-04-14

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): I feel fantastic! Thanks!

Release 11 — day 7, dose 4

2022-04-19

Systemic reaction (other): No

Release 12 — day 0, dose 5

2022-12-13

Systemic reaction (other): It's early. I get a very uncomfortable reaction overnight following all of these shots so far. Onset of problems after eight hours or so.

Release 12 — days 1–6 daily, dose 5

2022-12-18

Systemic reaction (other): No

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
SRO	Emergency care	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Pleurisy	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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