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ZT9-17779-21186

6 vaccinations 11 coded responses 46 check-ins 11 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
954 / CA
Registered
2021-02-15
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-15
    Registered in v-safe
  2. 2021-02-15
    Dose 1 — Moderna
  3. 2021-02-15
    Health check-in — day 0, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  4. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea
    Free text: Generally tired the last couple of days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness, Diarrhea
    Adult check-in
  7. 2021-02-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Vomiting — Feeling: Fair · Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Free text: Threw up last night, better this morning
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-20
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Fair · Muscle or body aches
    Free text: Not So tired, Getting back to work
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness, Diarrhea
    Adult check-in
  10. 2021-02-22
    Survey response — day 7, dose 1
    MedDRA: Abdominal discomfort — Feeling: Good · Abdominal pain
    Free text: Light stomach discomfort
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-01
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-08
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  13. 2021-03-15
    Dose 2 — Moderna
  14. 2021-03-15
    Survey response — day 0, dose 2
    MedDRA: Condition aggravated, Fatigue, Pain, Pre-existing disease — Feeling: Good · Fatigue or tiredness · Be unable to work
    Free text: Just had cervical surgery March 11, recovering nicely. The vaccination didnt have a permanent affect. The achy feeling is definitely the operation, and mostly the fatigue is as well. Didnt notice any market increase in symptoms after the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Hypersomnia — Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Felt very tired yesterday and today up till dinner time. Sleeping a lot is helping
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Bed rest, Fatigue, Pain, Somnolence — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Free text: Basically tired and achy. Slept twice as much as normal and Im starting to feel much better. Needed a lot of rest.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hyperhidrosis — Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tiredness · Be unable to work
    Free text: Once in a while briefly sweating, that has been happening since the injection but its very minor. All symptoms are slowly diminishing
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness
    Free text: Little better every day. One more week to full vaccination
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-03-22
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-29
    Survey response — day 14, dose 2
    MedDRA: Abnormal dreams, Anxiety, Disturbance in attention, Fear, Feeling abnormal, Nightmare, Poor quality sleep, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Waking after less than optimum sleep in fear or anxiety, dreams of claustrophobia. Noticing how fuzzy my thinking can be, the difficulty in concentrating energy. Still recovering from surgery a week before my second shot, I think symptoms are mixed. · Healthcare visit (other): Set up appointment with psychologist about sleep patterns
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-03-29
    Report sent to call center — day 14, dose 2
    Be unable to work · Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2021-04-05
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-12
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-19
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  26. 2021-09-13
    Survey response — 6 months, dose 2
    MedDRA: Haematoma, Hospitalisation, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Spontaneous Iliopsoas hematoma Right hip. Hospitalized five days, unrelated to Covid, Tested Covid negative
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-10-20
    Dose 3 — Moderna
  28. 2021-10-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  29. 2021-10-27
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-11-03
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  31. 2021-11-10
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-11-17
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  33. 2021-11-24
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-12-04
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  35. 2022-01-19
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-03-09
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  37. 2022-04-15
    Dose 4 — Moderna
  38. 2022-04-16
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  39. 2022-04-17
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  40. 2022-04-18
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  41. 2022-04-19
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  42. 2022-04-20
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  43. 2022-04-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  44. 2022-04-22
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  45. 2022-04-29
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-05-06
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  47. 2022-05-13
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  48. 2022-05-22
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-05-27
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  50. 2022-07-15
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  51. 2022-09-10
    Dose 5 — Moderna
    Co-administered: Flu
  52. 2023-04-24
    Dose 6 — Pfizer-BioNTech
  53. 2023-04-24
    Health check-in — day 0, dose 6
    Feeling: Good · None
    Adult check-in
  54. 2023-04-25
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · None
    Adult check-in
  55. 2023-04-26
    Health check-in — days 1–6 daily, dose 6
    Feeling: Good · None
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-15Moderna
22021-03-15Moderna
32021-10-20Moderna No
42022-04-15Moderna No
52022-09-10Moderna Flu
62023-04-24Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-03-29 Successful
2022-03-09
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-17

Systemic reaction (other): Generally tired the last couple of days

2021-02-19

Systemic reaction (other): Threw up last night, better this morning

2021-02-20

Systemic reaction (other): Not So tired, Getting back to work

Release 4 — day 7, dose 1

2021-02-22

Systemic reaction (other): Light stomach discomfort

Release 5 — day 0, dose 2

2021-03-15

Systemic reaction (other): Just had cervical surgery March 11, recovering nicely. The vaccination didnt have a permanent affect. The achy feeling is definitely the operation, and mostly the fatigue is as well. Didnt notice any market increase in symptoms after the shot.

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Felt very tired yesterday and today up till dinner time. Sleeping a lot is helping

2021-03-17

Systemic reaction (other): Basically tired and achy. Slept twice as much as normal and Im starting to feel much better. Needed a lot of rest.

Release 6 — days 1–6 daily, dose 2

2021-03-19

Systemic reaction (other): Once in a while briefly sweating, that has been happening since the injection but its very minor. All symptoms are slowly diminishing

2021-03-21

Systemic reaction (other): Little better every day. One more week to full vaccination

Release 6 — day 14, dose 2

2021-03-29

Symptoms: Waking after less than optimum sleep in fear or anxiety, dreams of claustrophobia. Noticing how fuzzy my thinking can be, the difficulty in concentrating energy. Still recovering from surgery a week before my second shot, I think symptoms are mixed. cut off by CDC
Healthcare visit (other): Set up appointment with psychologist about sleep patterns

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: Spontaneous Iliopsoas hematoma Right hip. Hospitalized five days, unrelated to Covid, Tested Covid negative

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDAbnormal dreams ✓ · ✓
SDAnxiety ✓ · ✓
SDDisturbance in attention ✓ ✓ ✓
SDFear ✓ · ✓
SDFeeling abnormal ✓ ✓ ✓
SDHaematoma · · ✓
SDHospitalisation · · ✓
SDNightmare ○ ✓ ○
SDPoor quality sleep ✓ ✓ ✓
SDPre-existing disease ✓ · ✓
SDSARS-CoV-2 test negative · · ✓
SROAbdominal discomfort ✓ ✓ ✓
SROBed rest ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROHypersomnia ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROSomnolence ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓
SROVomiting ✓ ✓ ✓

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

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