25Z-15630-81222

2 vaccinations 11 coded responses 17 check-ins 11 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 070 / NJ
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Survey response — day 0, dose 1
MedDRA: Cough — Feeling: Fair

Free text: Chronic cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac disorder, Chronic obstructive pulmonary disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Some of these could be from my COPD or heart problems.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Chronic cough due to COPD and heart issues, not vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chronic cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 7, dose 1
MedDRA: Cough, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Chronic cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-09
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-16
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-02-23
Survey response — day 7, dose 2
MedDRA: Chronic obstructive pulmonary disease, Cough — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chronic cough, COPD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 14, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Chronic cough and lung rattles are worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 21, dose 2
MedDRA: Fatigue, Total lung capacity decreased — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: My lung capacity seems to have diminished and I tire easily.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 28, dose 2
MedDRA: Cough, Pain, Productive cough, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fever, one day, of 101.4 with body aches. Body aches stayed for a couple of days. Yesterday and today, I have rattling in my lungs and worse cough than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Survey response — 3 months, dose 2
MedDRA: Cataract, Cough — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, 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: Wet AMD, cararacts, increased, severe coughing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
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)
2021-08-17
Survey response — 6 months, dose 2
MedDRA: Asthenia, Body temperature increased, Cough, Fatigue, Myalgia, Urinary incontinence — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Every so often I get horrendous coughing fits, sometimes have achy muscles and low grade temperature. I get a feeling of being worn out and my life draining. Then, in a day or more,, not so bad. Lisa if urinary control when coughing is bad or exertio

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-04-28
Call 1 — Left Voicemail
2022-04-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-16	Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Chronic cough

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Some of these could be from my COPD or heart problems.

2021-01-24

Systemic reaction (other): Chronic cough due to COPD and heart issues, not vaccine

2021-01-25

Systemic reaction (other): Chronic cough.

Release 2 — day 7, dose 1

2021-01-26

Systemic reaction (other): Chronic cough

Release 4 — day 7, dose 2

2021-02-23

Systemic reaction (other): Chronic cough, COPD

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Chronic cough and lung rattles are worse.

Release 5 — day 21, dose 2

2021-03-09

Symptoms: My lung capacity seems to have diminished and I tire easily.

Release 5 — day 28, dose 2

2021-03-16

Symptoms: Fever, one day, of 101.4 with body aches. Body aches stayed for a couple of days. Yesterday and today, I have rattling in my lungs and worse cough than usual.

Release 8 — 3 months, dose 2

2021-05-20

Symptoms: Wet AMD, cararacts, increased, severe coughing.

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Every so often I get horrendous coughing fits, sometimes have achy muscles and low grade temperature. I get a feeling of being worn out and my life draining. Then, in a day or more,, not so bad. Lisa if urinary control when coughing is bad or exertio cut off by CDC

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	Body temperature increased	✓	·	✓
SD	Cataract	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Myalgia	✓	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Total lung capacity decreased	✓	✓	✓
SD	Urinary incontinence	✓	·	✓
SRO	Cardiac disorder	✓	✓	✓
SRO	Chronic obstructive pulmonary disease	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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