ZCR-15501-39496

4 vaccinations 8 coded responses 46 check-ins 7 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 070 / NJ
Registered: 2021-01-20

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

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Moderna
2021-01-20
Survey response — day 0, dose 1
MedDRA: Heart rate increased — Feeling: Good

Free text: pulse is elevated- 120bpm, which is twice my sual resting pulse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Blister — Feeling: Good

Free text: I have new blisters on the second-to-little toe on each foot. They might just be ordinary blisters, but I've never had blisters there before, so I thought I should mention them, since I hear about covid toes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Survey response — day 0, dose 2
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain

Free text: I still have a mild case of covid toes that came on after the first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 21, dose 2
MedDRA: Ear discomfort — Feeling: Good

Free text: Odd and very uncomfortable pulsing sensation in right ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — 3 months, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Cough — Feeling: Good

Free text: Persistent cough

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-25
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Fever · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

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

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-02
Dose 4 — Moderna
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-30
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-02
Survey response — 3 months, dose 4
MedDRA: COVID-19, Cough, Fatigue, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid: fever, cough, fatigue. Including rebound after Paxlovid treatment.

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Report sent to call center — 3 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-05
Call 1 — Could Not Reach Participant
2022-07-05
Call successful
Participant prefers to complete VAERS report online
2022-10-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-04
Survey response — 12 months, dose 4
MedDRA: Cough, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-10-25	Moderna	No
4	2022-04-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-02	Successful 2022-07-05	Participant prefers to complete VAERS report online

Free text

Release 2 — day 0, dose 1

2021-01-20

Systemic reaction (other): pulse is elevated- 120bpm, which is twice my sual resting pulse

Release 3 — day 14, dose 1

2021-02-03

Symptoms: I have new blisters on the second-to-little toe on each foot. They might just be ordinary blisters, but I've never had blisters there before, so I thought I should mention them, since I hear about covid toes.

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): I still have a mild case of covid toes that came on after the first dose.

Release 5 — day 21, dose 2

2021-03-10

Symptoms: Odd and very uncomfortable pulsing sensation in right ear

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: Joint pain

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Persistent cough

Release 12 — 3 months, dose 4

2022-07-02

Symptoms: Covid: fever, cough, fatigue. Including rebound after Paxlovid treatment.

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	Arthralgia	✓	✓	✓
SD	Blister	✓	✓	✓
SD	Cough	✓	·	✓
SD	COVID-19	·	·	✓
SD	Ear discomfort	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Immunisation reaction	✓	✓	✓

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