267-33806-99900

2 vaccinations 12 coded responses 24 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 934 / CA
Registered: 2021-09-21

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

2021-09-21
Registered in v-safe
2021-09-21
Dose 1 — Moderna
2021-09-21
Survey response — day 0, dose 1
MedDRA: Dizziness, Euphoric mood — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Head rush after injection and now some euphoria

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Survey response — days 1–6 daily, dose 1
MedDRA: Euphoric mood — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Euphoria feeling

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-09-24
Survey response — days 1–6 daily, dose 1
MedDRA: Euphoric mood — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Still having euphoria feeling in my head

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Survey response — days 1–6 daily, dose 1
MedDRA: Euphoric mood, Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Had moderate euphoria today and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-09-26
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Moderate fatigue since vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-10-05
Survey response — day 14, dose 1
MedDRA: Asthenia, Body temperature increased, Fatigue, Rhinorrhoea, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Off and on feverish. Temp of 100. Slight runny nose and a girgling behind my ears. No energy to speak of and get exhausted at the slightest exertion.

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Bad headaches

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Dose 2 — Moderna
2021-10-19
Survey response — day 0, dose 2
MedDRA: Euphoric mood — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Euphoria like a hangover feeling

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The body aches started on my left side as the left arm is where I received the shot. The pains have migrated to the right side of my body as well.

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-11
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-11-16
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-11-23
Survey response — day 35, dose 2
MedDRA: Fatigue, Malaise, Oropharyngeal pain, Sputum discoloured — Feeling: Poor

Free text: I have a bad sore throat for a week now with extreme fatigue. I also have been spitting up brown mucus. Just feel real lousy for a week now. It started after my last check-in.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Survey response — day 42, dose 2
MedDRA: Asthenia, Cough, Oropharyngeal pain, Sputum discoloured — Feeling: Poor

Free text: Bad sore throat for two weeks now as well as a cough and brown mucus. No energy!

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Survey response — 3 months, dose 2
MedDRA: COVID-19, Malaise — Feeling: Poor · Be unable to work or attend school, 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: I have Covid. Been very sick.

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-19
Call 1 — Left Voicemail
2022-01-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-21	Moderna	No
2	2021-10-19	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 9 — day 0, dose 1

2021-09-21

Systemic reaction (other): Head rush after injection and now some euphoria

Release 9 — days 1–6 daily, dose 1

2021-09-22

Systemic reaction (other): Euphoria feeling

2021-09-24

Systemic reaction (other): Still having euphoria feeling in my head

2021-09-25

Systemic reaction (other): Had moderate euphoria today and fatigue.

2021-09-26

Systemic reaction (other): Moderate fatigue since vaccine

Release 10 — day 14, dose 1

2021-10-05

Symptoms: Off and on feverish. Temp of 100. Slight runny nose and a girgling behind my ears. No energy to speak of and get exhausted at the slightest exertion.

Release 10 — day 21, dose 1

2021-10-12

Symptoms: Bad headaches

Release 10 — day 0, dose 2

2021-10-19

Systemic reaction (other): Euphoria like a hangover feeling

Release 10 — days 1–6 daily, dose 2

2021-10-20

Systemic reaction (other): The body aches started on my left side as the left arm is where I received the shot. The pains have migrated to the right side of my body as well.

Release 10 — day 35, dose 2

2021-11-23

Symptoms: I have a bad sore throat for a week now with extreme fatigue. I also have been spitting up brown mucus. Just feel real lousy for a week now. It started after my last check-in.

Release 10 — day 42, dose 2

2021-11-30

Symptoms: Bad sore throat for two weeks now as well as a cough and brown mucus. No energy!

Release 10 — 3 months, dose 2

2022-01-18

Symptoms: I have Covid. Been very sick.

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sputum discoloured	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Euphoric mood	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Pain	·	·	✓

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