ZLJ-17900-61881

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 4 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 201 / VA
Registered: 2021-01-26

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Health check-in — day 0, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · 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
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Cough — Feeling: Good

Free text: Lingering cough from side effects

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph nodes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Survey response — day 28, dose 2
MedDRA: Chest pain, Fatigue, Hospitalisation — Feeling: Poor · 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: Been having fatigue. Currently in hospital for chest pains.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 28, 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)
2021-03-31
Survey response — day 35, dose 2
MedDRA: Electrocardiogram abnormal, Hospitalisation, Myocardial infarction — 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: I was hospitalized for what was initially a possible heart attack. Something changed in my EKG. no idea if it would be related to my vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 35, 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)
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Asthenia, Muscle spasms, Oesophageal spasm — 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: Chest spasms. Originally suspected as a possible H/A, my esophagus has been spasming only starting after my vaccination. I have no idea about potential correlation or causation. I have not regained full energy as existed prior to the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
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)
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-28
Call successful
Participant prefers to complete VAERS report online
2022-02-24
Survey response — 12 months, dose 2
MedDRA: Hepatomegaly, Multi-organ disorder, Splenomegaly — 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 · Outpatient clinic or urgent care clinic visit

Free text: I have started having sporadic problems with my internal organs to include enlarged live r & spleen.

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-28
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-24	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-26	Successful	Participant prefers to complete VAERS report online
2021-03-31	Successful	Participant prefers to complete VAERS report online
2021-05-28	Successful 2021-12-28	Participant prefers to complete VAERS report online
2022-02-24	Successful 2022-02-28	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Lingering cough from side effects

2021-03-02

Systemic reaction (other): Swollen lymph nodes.

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Been having fatigue. Currently in hospital for chest pains.

Release 6 — day 35, dose 2

2021-03-31

Symptoms: I was hospitalized for what was initially a possible heart attack. Something changed in my EKG. no idea if it would be related to my vaccination.

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Chest spasms. Originally suspected as a possible H/A, my esophagus has been spasming only starting after my vaccination. I have no idea about potential correlation or causation. I have not regained full energy as existed prior to the vaccination.

Release 11 — 12 months, dose 2

2022-02-24

Symptoms: I have started having sporadic problems with my internal organs to include enlarged live r & spleen.

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	Asthenia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Electrocardiogram abnormal	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hepatomegaly	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Multi-organ disorder	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Myocardial infarction	✓	✓	✓
SD	Oesophageal spasm	✓	✓	✓
SD	Splenomegaly	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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