ZMJ-10735-86599

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 980 / WA
Registered: 2021-04-24

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-24
Registered in v-safe
2021-04-24
Dose 1 — Moderna
2021-04-24
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Disturbance in attention — Feeling: Good · Headache, Fatigue or tiredness, Nausea, Diarrhea

Free text: Foggy-headed, difficulty concentrating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Nausea

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Diarrhea

Adult check-in
2021-05-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-22
Dose 2 — Moderna
2021-05-22
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-05-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-25
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Poor · Site: Pain · Fever · 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: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Brain Fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Good · Joint pains, Muscle or body aches

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — day 7, dose 2
MedDRA: Brain fog — Feeling: Good · Joint pains, Muscle or body aches

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-19
Survey response — day 28, dose 2
MedDRA: Feeling hot, Injection site pain, Joint swelling, Office visit, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: I just realized this weekend that the pain at the injection site hasn't completely gone away. Additionally, I've been experiencing swelling in joints that were previously damaged and warmth in the shoulder · Healthcare visit (other): Seeing a rheumatologist this week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-19
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-26
Survey response — day 35, dose 2
MedDRA: Injection site pain, Peripheral swelling — Feeling: Good

Free text: Injection site has been becoming more sore. I have two swollen toes now, speaking with a rheumatologist about them.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Call successful
Participant prefers to complete VAERS report online
2021-07-03
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-20
Survey response — 6 months, dose 2
MedDRA: Myocardial infarction — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Heart attack - NSTEMI

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-24
Call successful
Participant prefers to complete VAERS report online
2022-05-22
Survey response — 12 months, dose 2
MedDRA: Erythema, Peripheral swelling — Feeling: Good

Free text: One of my toes ended up red and super swollen, outside of the swelling I'm experiencing in my other fingers and toes.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-24	Moderna
2	2021-05-22	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-19	Successful 2021-06-28	Participant prefers to complete VAERS report online
2021-11-20	Successful 2021-11-24	Participant prefers to complete VAERS report online

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-28

Systemic reaction (other): Foggy-headed, difficulty concentrating

Release 8 — days 1–6 daily, dose 2

2021-05-25

Systemic reaction (other): Brain fog

2021-05-26

Systemic reaction (other): Brain Fog

2021-05-27

Systemic reaction (other): Brain fog

2021-05-28

Systemic reaction (other): Brain fog

Release 8 — day 7, dose 2

2021-05-29

Systemic reaction (other): Brain fog

Release 9 — day 28, dose 2

2021-06-19

Symptoms: I just realized this weekend that the pain at the injection site hasn't completely gone away. Additionally, I've been experiencing swelling in joints that were previously damaged and warmth in the shoulder

Healthcare visit (other): Seeing a rheumatologist this week

Release 9 — day 35, dose 2

2021-06-26

Symptoms: Injection site has been becoming more sore. I have two swollen toes now, speaking with a rheumatologist about them.

Release 10 — 6 months, dose 2

2021-11-20

Symptoms: Heart attack - NSTEMI

Release 11 — 12 months, dose 2

2022-05-22

Symptoms: One of my toes ended up red and super swollen, outside of the swelling I'm experiencing in my other fingers and toes.

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	✓	✓	○
HCVO	Unevaluable event	·	·	✓
SD	Erythema	·	·	✓
SD	Feeling hot	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Myocardial infarction	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓

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