ZCV-25140-93928

4 vaccinations 21 coded responses 47 check-ins 20 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 601 / IL
Registered: 2021-03-24

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very lethargic in the afternoons, around 2-3 pm, for few hours. Super low energy until I have caffeine, or a sugar snack.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-21
Dose 2 — Moderna
2021-04-21
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Lethargy, Tinnitus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Tinnitus, extreme lethargy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Lethargy, Tinnitus — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Tinnitus and lethargy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Testicular disorder, Tinnitus — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Tinnitus: one testicle is lower than the other 2.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Dyspnoea, Fatigue — Feeling: Poor · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Chest pain and severe fatigue, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-05
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, to the point of ibs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Survey response — day 28, dose 2
MedDRA: Fatigue, Irritable bowel syndrome — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Fatigue, all the time.I.B.S,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-21
Survey response — 3 months, dose 2
MedDRA: Bone pain, Chest pain, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lethargy,Chest painsAches and pains in bones

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Survey response — 6 months, dose 2
MedDRA: Arthralgia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme pain in shoulder where I received the injections. Has worsened over the past month.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Dose 3 — Moderna
2021-10-30
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, 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 · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-11-13
Survey response — day 14, dose 3
MedDRA: Occult blood positive — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I tested positive on a fecal occult test, no history of ulcer or

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-15
Call 1 — Left Voicemail
2021-11-20
Survey response — day 21, dose 3
MedDRA: Haematochezia — Feeling: Fair

Free text: Hematoschezia

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 28, dose 3
MedDRA: Abdominal pain, Haematochezia — Feeling: Poor · Be unable to work or attend school

Free text: Hematoschezia, to the point of concern. I have abdominal pain, and blood in my stool.

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Survey response — day 35, dose 3
MedDRA: Abdominal pain, Abdominal tenderness, Haematochezia, Swelling — Feeling: Poor · Be unable to do your normal daily activities

Free text: Hematoschezia, abdominal pain and tenderness, goiter like swelling above my collar bones

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Health check-in — day 42, dose 3
Feeling: Fair

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

Adult check-in
2022-03-29
Dose 4 — Moderna
2022-04-18
Survey response — day 14, dose 4
MedDRA: Testicular cyst — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Testicular cysts

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-04-28
Survey response — day 28, dose 4
MedDRA: Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Survey response — day 35, dose 4
MedDRA: Office visit, Testicular cyst, Testicular pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: The testicular cysts are quite painful, I have seen a specialist, surgery is scheduled

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-06-28
Health check-in — 3 months, dose 4
Feeling: Poor

Adult check-in
2022-09-27
Survey response — 6 months, dose 4
MedDRA: COVID-19, Hernia, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Finally diagnosed with a hernia. Having heart palpitations ever since my Covid infection

MedDRA releases: 2024-11 · check-in free text available
2023-03-30
Survey response — 12 months, dose 4
MedDRA: Asthenia, Ventricular extrasystoles — 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	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2021-10-30	Moderna	No
4	2022-03-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-13	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-07

Symptoms: Very lethargic in the afternoons, around 2-3 pm, for few hours. Super low energy until I have caffeine, or a sugar snack.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Tinnitus

2021-04-23

Systemic reaction (other): Tinnitus, extreme lethargy

2021-04-24

Systemic reaction (other): Tinnitus

2021-04-25

Systemic reaction (other): Tinnitus and lethargy

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Tinnitus: one testicle is lower than the other 2.

2021-04-27

Systemic reaction (other): Chest pain and severe fatigue, shortness of breath

Release 8 — day 14, dose 2

2021-05-05

Symptoms: Diarrhea, to the point of ibs

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Fatigue, all the time.I.B.S,

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Severe fatigue

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: Lethargy,Chest painsAches and pains in bones

Release 10 — 6 months, dose 2

2021-10-23

Symptoms: Extreme pain in shoulder where I received the injections. Has worsened over the past month.

Release 10 — day 14, dose 3

2021-11-13

Symptoms: I tested positive on a fecal occult test, no history of ulcer or

Release 10 — day 21, dose 3

2021-11-20

Symptoms: Hematoschezia

Release 10 — day 28, dose 3

2021-11-27

Symptoms: Hematoschezia, to the point of concern. I have abdominal pain, and blood in my stool.

Release 10 — day 35, dose 3

2021-12-04

Symptoms: Hematoschezia, abdominal pain and tenderness, goiter like swelling above my collar bones

Release 11 — day 14, dose 4

2022-04-18

Symptoms: Testicular cysts

Release 11 — day 28, dose 4

2022-04-28

Symptoms: Heart palpitations

Release 11 — day 35, dose 4

2022-05-03

Symptoms: The testicular cysts are quite painful, I have seen a specialist, surgery is scheduled

Release 12 — 6 months, dose 4

2022-09-27

Symptoms: Finally diagnosed with a hernia. Having heart palpitations ever since my Covid infection

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	Abdominal pain	·	·	✓
SD	Abdominal tenderness	·	·	✓
SD	Arthralgia	·	·	✓
SD	Asthenia	·	·	✓
SD	Bone pain	·	·	✓
SD	Chest pain	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Haematochezia	·	·	✓
SD	Hernia	·	·	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Occult blood positive	·	·	✓
SD	Office visit	·	·	✓
SD	Palpitations	·	·	✓
SD	Swelling	·	·	✓
SD	Testicular cyst	·	·	✓
SD	Testicular pain	·	·	✓
SD	Ventricular extrasystoles	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Testicular disorder	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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