263-25539-02366

4 vaccinations 17 coded responses 52 check-ins 16 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 840 / UT
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Mild shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Survey response — day 14, dose 1
MedDRA: Unevaluable event — Feeling: Fair

Free text: Had a moderate allergic reaction to a food I have never been allergic to last night. It was really strange. I recognized it because I have been anaphylactic to dairy since childhood. Reaction was to onion. Ate onions again today and I was fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise — Feeling: Poor · Site: Pain, Itching · 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: A short temper from not feeling well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal dreams, Dyspepsia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: mild heartburn, extremely lucid dreams

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain

Free text: Difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Mild difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Depression, Dyspnoea — Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Free text: Mild Constipation, mild feeling out of breath, and mild depression.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 7, dose 2
MedDRA: Dyspepsia — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Moderate Heartburn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 2
MedDRA: Gastritis, Pre-existing disease, Therapeutic response unexpected — Feeling: Good

Free text: Long Covid symptoms have improved significantly and gastritis that Ive had for past six months has improved. Overall, my overall health and well being has improved significantly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Survey response — 6 months, dose 2
MedDRA: Appendicectomy, Condition aggravated, Emergency care, Intestinal resection, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Had an emergency appendectomy with removal of 4 inches of my bowel and a bowel resection. Appendix was chronically inflamed for months before its removal according to the surgeon has been. I am currently recovering.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-29
Dose 3 — Moderna
2021-12-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-12-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Nausea, Diarrhea

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Nausea, Diarrhea

Adult check-in
2022-01-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Nausea, Diarrhea

Adult check-in
2022-01-05
Health check-in — day 7, dose 3
Feeling: Good · Joint pains, Nausea

Adult check-in
2022-01-12
Survey response — day 14, dose 3
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Good

Free text: Runny nose and congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Survey response — day 21, dose 3
MedDRA: Pre-existing disease — Feeling: Good

Free text: Improvement in long Covid symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-30
Survey response — 3 months, dose 3
MedDRA: Anosmia, Influenza — Feeling: Good · Be unable to do your normal daily activities

Free text: Lost smell for a couple of weeks. Also caught the flu.

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-15
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-17
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Constipation

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-09-22
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-13
Survey response — day 28, dose 4
MedDRA: Constipation, Pre-existing disease — Feeling: Fair

Free text: Constipation and food allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-15
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-16
Survey response — 6 months, dose 4
MedDRA: COVID-19, Dyspepsia, Post-acute COVID-19 syndrome — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-15	Moderna
3	2021-12-29	Moderna	No
4	2022-09-15	Pfizer-BioNTech	Flu

Call center

1 call center case

1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Shortness of breath

2021-01-16

Systemic reaction (other): Mild shortness of breath

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Had a moderate allergic reaction to a food I have never been allergic to last night. It was really strange. I recognized it because I have been anaphylactic to dairy since childhood. Reaction was to onion. Ate onions again today and I was fine.

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): A short temper from not feeling well.

2021-02-18

Systemic reaction (other): mild heartburn, extremely lucid dreams

2021-02-19

Systemic reaction (other): Difficulty breathing

2021-02-20

Systemic reaction (other): Mild difficulty breathing

2021-02-21

Systemic reaction (other): Mild Constipation, mild feeling out of breath, and mild depression.

Release 4 — day 7, dose 2

2021-02-22

Systemic reaction (other): Moderate Heartburn

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Long Covid symptoms have improved significantly and gastritis that Ive had for past six months has improved. Overall, my overall health and well being has improved significantly.

Release 9 — 6 months, dose 2

2021-08-16

Symptoms: Had an emergency appendectomy with removal of 4 inches of my bowel and a bowel resection. Appendix was chronically inflamed for months before its removal according to the surgeon has been. I am currently recovering.

Release 10 — day 14, dose 3

2022-01-12

Symptoms: Runny nose and congestion.

Release 10 — day 21, dose 3

2022-01-19

Symptoms: Improvement in long Covid symptoms.

Release 11 — 3 months, dose 3

2022-03-30

Symptoms: Lost smell for a couple of weeks. Also caught the flu.

Release 12 — days 1–6 daily, dose 4

2022-09-17

Systemic reaction (other): Constipation

Release 12 — day 28, dose 4

2022-10-13

Symptoms: Constipation and food allergies.

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	Anosmia	·	·	✓
SD	Appendicectomy	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Constipation	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Emergency care	✓	·	✓
SD	Gastritis	✓	✓	✓
SD	Influenza	·	·	✓
SD	Intestinal resection	✓	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Therapeutic response unexpected	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Malaise	✓	✓	✓

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