2AX-24926-90799

3 vaccinations 14 coded responses 40 check-ins 14 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 179 / PA
Registered: 2021-03-20

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

2021-03-19
Dose 1 — Moderna
2021-03-20
Registered in v-safe
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — day 7, dose 1
MedDRA: Disturbance in attention — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: A little difficult to concentrate

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

Adult check-in
2021-04-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Survey response — day 0, dose 2
MedDRA: Dizziness, Headache — Feeling: Good · Site: Pain · Headache

Free text: Slight dizziness combined with mild headache when around bright lights. Both go away in darker room or environment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Poor · Site: Pain · 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: Hip joints was painful in the morning and was difficult to find a comfortable position. This has diminished and is now gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth, Dry throat, Nasal dryness — Feeling: Good · Site: Pain · Headache

Free text: Wanted to add that my nose, mouth, and throat was very dry on Saturday. This would cause a tickling sensation that would either make you cough or give you the sensation to vomit. This has gotten better today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation — Feeling: Good

Free text: I was constipated over the weekend but that cleared up Tuesday evening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 28, dose 2
MedDRA: Dry skin — Feeling: Good

Free text: I have a small patch of dry skin on both sides of my nose. I got it after my second shot. I have to put moisturizer on it and if I stop it comes back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-28
Dose 3 — Moderna
2021-12-28
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-29
Survey response — days 1–6 daily, dose 3
MedDRA: Dry mouth, Nasal dryness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dry mouth and nose

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Dry mouth — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Dry mouth that causes a ticklish cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral, Swelling — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: The swelling I got has spread to my left arm pit. I noticed this yesterday afternoon.

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain, Swelling

Free text: Pain and swelling is still noticeable in left armpit but is subsiding

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-04
Survey response — day 7, dose 3
MedDRA: Dry mouth — Feeling: Good · Headache

Free text: Dry mouth

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-18
Survey response — day 21, dose 3
MedDRA: Cough, Dry mouth, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: I have a persistent dry mouth that caused me to occasionally cough. Had this since I got the booster shot and also after the second shot.

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-29
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Fatigue — Feeling: Good

Free text: Fatigue and joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-30
Survey response — 12 months, dose 3
MedDRA: Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Autoimmune disorder IgG4 · Healthcare visit (other): Visit to my primary health doctor

MedDRA releases: 2024-11 · check-in free text available
2022-12-30
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-03
Call 1 — Could Not Reach Participant
2023-01-06
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna
3	2021-12-28	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-03-26

Systemic reaction (other): A little difficult to concentrate

Release 7 — day 0, dose 2

2021-04-16

Systemic reaction (other): Slight dizziness combined with mild headache when around bright lights. Both go away in darker room or environment

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Hip joints was painful in the morning and was difficult to find a comfortable position. This has diminished and is now gone.

2021-04-18

Systemic reaction (other): Wanted to add that my nose, mouth, and throat was very dry on Saturday. This would cause a tickling sensation that would either make you cough or give you the sensation to vomit. This has gotten better today.

2021-04-21

Systemic reaction (other): I was constipated over the weekend but that cleared up Tuesday evening

Release 8 — day 28, dose 2

2021-05-14

Symptoms: I have a small patch of dry skin on both sides of my nose. I got it after my second shot. I have to put moisturizer on it and if I stop it comes back.

Release 10 — days 1–6 daily, dose 3

2021-12-29

Systemic reaction (other): Dry mouth and nose

2021-12-30

Systemic reaction (other): Dry mouth that causes a ticklish cough

2021-12-31

Systemic reaction (other): The swelling I got has spread to my left arm pit. I noticed this yesterday afternoon.

2022-01-01

Systemic reaction (other): Pain and swelling is still noticeable in left armpit but is subsiding

Release 10 — day 7, dose 3

2022-01-04

Systemic reaction (other): Dry mouth

Release 10 — day 21, dose 3

2022-01-18

Symptoms: I have a persistent dry mouth that caused me to occasionally cough. Had this since I got the booster shot and also after the second shot.

Release 11 — 3 months, dose 3

2022-03-29

Symptoms: Fatigue and joint pain

Release 12 — 12 months, dose 3

2022-12-30

Symptoms: Autoimmune disorder IgG4

Healthcare visit (other): Visit to my primary health doctor

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	Arthralgia	·	·	✓
SD	Cough	·	·	✓
SD	Dry mouth	·	·	✓
SD	Dry skin	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Constipation	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dry throat	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nasal dryness	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Swelling	·	·	✓

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