ZVB-33145-32657

4 vaccinations 10 coded responses 38 check-ins 10 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 423 / KY
Registered: 2021-03-07

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

2021-02-07
Dose 1 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Dose 2 — Moderna
2021-03-07
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Fever · Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: symptoms may be related to possible exposure stomach flue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Sensitive skin — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: slight increase in skin hypersensitivity( Alpha-gal positive).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-04
Survey response — day 28, dose 2
MedDRA: Back pain, Sciatica — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Sciatic pain in lower right back. Got steroid shot.

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

1 call case(s)
2021-04-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-18
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Increased heart problems. Increase in PVC. Currently wearing heart monitor. Under goingheart tests.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Survey response — 3 months, dose 2
MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-06-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-06-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Survey response — day 35, dose 3
MedDRA: Sciatica — Feeling: Good · Be unable to do your normal daily activities

Free text: Increased siatica

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-20
Dose 4 — Moderna
2022-06-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-06-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-24
Survey response — days 1–6 daily, dose 4
MedDRA: Back pain, Spinal operation — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: some back pain related to recent spinal surgery

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Survey response — days 1–6 daily, dose 4
MedDRA: Back pain — Feeling: Fair · Muscle or body aches

Free text: lower back pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-11
Survey response — day 21, dose 4
MedDRA: Blood pressure abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Blood pressure issues

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-12
Call successful
Participant prefers to complete VAERS report online
2022-07-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-19
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-12-19
Survey response — 6 months, dose 4
MedDRA: Office visit, Prostate cancer — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Prostrate cancer has increased in severity and will be treated with 'Proton therapy '. · Healthcare visit (other): office appointment with Urologist.

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-20
Call 1 — Left Voicemail
2023-06-23
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-07	Moderna
2	2021-03-07	Moderna
3	2021-10-23	Moderna	No
4	2022-06-20	Moderna	No

Call center

5 call center cases

4 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): symptoms may be related to possible exposure stomach flue

2021-03-10

Systemic reaction (other): slight increase in skin hypersensitivity( Alpha-gal positive).

Release 6 — day 28, dose 2

2021-04-04

Symptoms: Sciatic pain in lower right back. Got steroid shot.

Release 7 — day 42, dose 2

2021-04-18

Symptoms: Increased heart problems. Increase in PVC. Currently wearing heart monitor. Under goingheart tests.

Release 8 — 3 months, dose 2

2021-06-08

Symptoms: Bronchitis

Release 10 — day 35, dose 3

2021-11-27

Symptoms: Increased siatica

Release 12 — days 1–6 daily, dose 4

2022-06-24

Systemic reaction (other): some back pain related to recent spinal surgery

2022-06-25

Systemic reaction (other): lower back pain

Release 12 — day 21, dose 4

2022-07-11

Symptoms: Blood pressure issues

Release 12 — 6 months, dose 4

2022-12-19

Symptoms: Prostrate cancer has increased in severity and will be treated with 'Proton therapy '.

Healthcare visit (other): office appointment with Urologist.

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	Back pain	✓	✓	✓
SD	Blood pressure abnormal	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Prostate cancer	·	·	✓
SD	Sciatica	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sensitive skin	✓	✓	✓
SRO	Spinal operation	·	·	✓

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