ZFJ-56894-77377

2 vaccinations 13 coded responses 20 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 287 / NC
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
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Mild sore throat in the morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Mild sore throat this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dysphagia — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Some difficulty swallowing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 7, dose 1
MedDRA: Glossodynia, Odynophagia, Oropharyngeal pain — Feeling: Fair · Site: Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Tongue is sensitive. Throat hurts when swallowing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 14, dose 1
MedDRA: Giant cell arteritis, Headache, Neovascular age-related macular degeneration, Odynophagia, Oral pain, Pain in jaw — Feeling: Fair · 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: Symptoms: Severe headaches, mouth and jaw pain, discomfort swallowing, etc. Dr suspects Giant Cell Arteritis. Had temporal artery biopsy on 2/2/21. · Healthcare visit (other): Blood work, temporal artery biopsy, postponed treatment for wet AMD, etc

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Muscle or body aches, Nausea

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal discomfort, Trismus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Difficulty opening mouth, jaw and throat discomfort when swallowing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dysphagia, Glossodynia, Mastication disorder, Oral discomfort — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Difficulty opening mouth very wide. Tongue is sore on left side. Uncomfortable to chew or swallow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: C-reactive protein increased, Discomfort — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Elevated CRP blood level at 14.1. Mouth, tongue, jaw discomfort particularly when eating or swallowing. Suspected Temporal Arteritis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Oral discomfort, Tongue discomfort — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Continued mouth, tongue, and jaw discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-17
Survey response — day 28, dose 2
MedDRA: Headache, Pain in jaw, Pre-existing disease — Feeling: Fair

Free text: CRP blood rate back up to 31 and worsening symptoms of Temporal Arteritis (Giant Cell Arteritis) after 2nd dose of vaccine - headaches and jaw pain in particular.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 35, dose 2
MedDRA: Asthenia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Low energy and increased fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Abscess, Hospitalisation, Necrosis, Osteomyelitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Developed necrosis and osteomyelitis of the mandible and and abscess/infection in the chin which started seeping on its own resulting in a 9 day stay in the hospital and being discharged on 6 weeks of IV antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-03	Unsuccessful
2021-05-21	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Mild sore throat in the morning

2021-01-25

Systemic reaction (other): Mild sore throat this morning

2021-01-26

Systemic reaction (other): Some difficulty swallowing

Release 2 — day 7, dose 1

2021-01-27

Systemic reaction (other): Tongue is sensitive. Throat hurts when swallowing

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Severe headaches, mouth and jaw pain, discomfort swallowing, etc. Dr suspects Giant Cell Arteritis. Had temporal artery biopsy on 2/2/21.

Healthcare visit (other): Blood work, temporal artery biopsy, postponed treatment for wet AMD, etc

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): Blurry vision

2021-02-19

Systemic reaction (other): Difficulty opening mouth, jaw and throat discomfort when swallowing

2021-02-21

Systemic reaction (other): Difficulty opening mouth very wide. Tongue is sore on left side. Uncomfortable to chew or swallow.

2021-02-22

Systemic reaction (other): Elevated CRP blood level at 14.1. Mouth, tongue, jaw discomfort particularly when eating or swallowing. Suspected Temporal Arteritis.

2021-02-23

Systemic reaction (other): Continued mouth, tongue, and jaw discomfort.

Release 5 — day 28, dose 2

2021-03-17

Symptoms: CRP blood rate back up to 31 and worsening symptoms of Temporal Arteritis (Giant Cell Arteritis) after 2nd dose of vaccine - headaches and jaw pain in particular.

Release 6 — day 35, dose 2

2021-03-24

Symptoms: Low energy and increased fatigue.

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Developed necrosis and osteomyelitis of the mandible and and abscess/infection in the chin which started seeping on its own resulting in a 9 day stay in the hospital and being discharged on 6 weeks of IV antibiotics.

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	Impaired healing	○	○	○
HCVO	Neovascular age-related macular degeneration	✓	✓	✓
SD	Abscess	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Dysphagia	○	○	○
SD	Fatigue	✓	✓	✓
SD	Giant cell arteritis	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Necrosis	✓	✓	✓
SD	Odynophagia	✓	✓	✓
SD	Oral pain	✓	✓	✓
SD	Osteomyelitis	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	C-reactive protein increased	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dysphagia	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Mastication disorder	✓	✓	✓
SRO	Odynophagia	✓	✓	✓
SRO	Oral discomfort	✓	✓	✓
SRO	Oropharyngeal discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Tongue discomfort	✓	✓	✓
SRO	Trismus	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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