ZXM-15861-91396

2 vaccinations 7 coded responses 27 check-ins 6 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 977 / OR
Registered: 2022-01-07

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

2022-01-07
Registered in v-safe
2022-01-07
Dose 1 — Moderna
2022-01-07
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2022-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to work or attend school

Adult check-in
2022-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Nausea

Free text: Sore throat -- Mild

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2022-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2022-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2022-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2022-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2022-02-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2022-02-08
Dose 2 — Moderna
2022-02-08
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Nausea

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to work or attend school

Adult check-in
2022-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Nausea

Adult check-in
2022-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2022-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2022-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2022-02-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2022-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2022-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2022-03-15
Survey response — day 35, dose 2
MedDRA: Constipation, Faeces discoloured, Faeces pale, Pre-existing disease — Feeling: Good

Free text: Severe constipation. Stool has been clay/grayish in color when I can go. I have always had issues with the constipation due to IBS but it has been way worse as of late.

MedDRA releases: 2024-11 · check-in free text available
2022-03-24
Survey response — day 42, dose 2
MedDRA: Induration, Skin mass, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: It may be unrelated but I have located a hard lump on the lower right side of my penis, below the skin that is concerning. Will be following up with my doc... · Healthcare visit (other): Have to make an appointment

MedDRA releases: 2024-11 · check-in free text available
2022-03-24
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-28
Call 1 — Left Voicemail
2022-03-31
Call successful
Participant prefers to complete VAERS report online
2022-05-10
Survey response — 3 months, dose 2
MedDRA: Ageusia, COVID-19, Dyspnoea, Influenza like illness — Feeling: Poor · Be unable to work or attend school

Free text: Covid Shortness of breath Flu like symptoms Loss of taste

MedDRA releases: 2024-11 · check-in free text available
2022-08-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2023-02-10
Survey response — 12 months, dose 2
MedDRA: Blood cholesterol increased — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-01-07	Moderna	No
2	2022-02-08	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — day 0, dose 1

2022-01-07

Systemic reaction (other): Dizziness

Release 10 — days 1–6 daily, dose 1

2022-01-11

Systemic reaction (other): Sore throat -- Mild

Release 11 — day 0, dose 2

2022-02-08

Systemic reaction (other): Dizziness

Release 11 — day 35, dose 2

2022-03-15

Symptoms: Severe constipation. Stool has been clay/grayish in color when I can go. I have always had issues with the constipation due to IBS but it has been way worse as of late.

Release 11 — day 42, dose 2

2022-03-24

Symptoms: It may be unrelated but I have located a hard lump on the lower right side of my penis, below the skin that is concerning. Will be following up with my doc...

Healthcare visit (other): Have to make an appointment

Release 11 — 3 months, dose 2

2022-05-10

Symptoms: Covid Shortness of breath Flu like symptoms Loss of taste

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	Unevaluable event	·	·	✓
SD	Ageusia	·	·	✓
SD	Blood cholesterol increased	·	·	✓
SD	Constipation	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Faeces discoloured	·	·	✓
SD	Faeces pale	·	·	✓
SD	Induration	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Skin mass	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Oropharyngeal pain	·	·	✓

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