ZGL-50641-29563

4 vaccinations 9 coded responses 37 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 207 / MD
Registered: 2021-01-09

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

2021-01-06
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea — Feeling: Good

Free text: I felt a little nauseated for a few days, but actually better than after some previous flu shots.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — day 7, dose 1
Feeling: Good · Fever · Headache, Muscle or body aches, Nausea

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Moderna
2021-02-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: General malaise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 2
MedDRA: Malaise — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Woke up in middle of night feeling sick. Lasted about 1 hour.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 14, dose 2
MedDRA: Feeling abnormal, Influenza like illness — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: A few dsys sgo i felt my worst. Like i had the flu. Woke up the next day feeling fine. Ok since.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 35, dose 2
MedDRA: Feeling hot, Malaise — Feeling: Fair

Free text: Wake up in middle of night feeling hot and not well. Feel a little off in morning. Nothing serious.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 42, dose 2
MedDRA: Feeling abnormal, Malaise, Night sweats — Feeling: Good

Free text: Night sweats. Headaches. Malaise. Some occasional other odd feelings.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — 3 months, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Be unable to work, 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: After effects of post cataract surgery medications. · Healthcare visit (other): Follow up with eye doctor and allergist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
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)
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Dose 3 — Moderna
2021-10-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-05
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-04
Call successful
Not applicable - Accidental Reporting
2022-05-06
Survey response — day 28, dose 4
MedDRA: Abdominal discomfort, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: G I upset. Not sure why. · Healthcare visit (other): My primary care clinic.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-09
Call 1 — Left Voicemail
2022-05-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-20
Survey response — day 42, dose 4
MedDRA: Gastrointestinal viral infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: GI virus

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-23
Call 1 — Left Voicemail
2022-05-23
Call 2 — Left Voicemail
2022-05-23
Call 1 — Left Voicemail
2022-07-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-08
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna
3	2021-10-05	Moderna	No
4	2022-04-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-05	Successful 2022-05-04	Not applicable - Accidental Reporting
2022-05-06	Successful 2022-05-09	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-20	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): I felt a little nauseated for a few days, but actually better than after some previous flu shots.

Release 3 — days 1–6 daily, dose 2

2021-02-09

Systemic reaction (other): General malaise

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): Woke up in middle of night feeling sick. Lasted about 1 hour.

Release 4 — day 14, dose 2

2021-02-17

Symptoms: A few dsys sgo i felt my worst. Like i had the flu. Woke up the next day feeling fine. Ok since.

Release 5 — day 35, dose 2

2021-03-11

Symptoms: Wake up in middle of night feeling hot and not well. Feel a little off in morning. Nothing serious.

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Night sweats. Headaches. Malaise. Some occasional other odd feelings.

Release 8 — 3 months, dose 2

2021-05-05

Symptoms: After effects of post cataract surgery medications.

Healthcare visit (other): Follow up with eye doctor and allergist

Release 11 — day 28, dose 4

2022-05-06

Symptoms: G I upset. Not sure why.

Healthcare visit (other): My primary care clinic.

Release 11 — day 42, dose 4

2022-05-20

Symptoms: GI virus

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	Office visit	✓	✓	✓
SD	Abdominal discomfort	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Gastrointestinal viral infection	·	·	✓
SD	Influenza like illness	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓

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