2JK-36113-18433

2 vaccinations 10 coded responses 22 check-ins 10 free-text entries 3 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 443 / OH
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: Fair · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Headache, Office visit, Pain, Respiratory tract congestion, SARS-CoV-2 test — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Took a COVID test - cough, chest congestion, body aches, headache for 4 days · Healthcare visit (other): COVID test at a clinic

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 work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: SARS-CoV-2 test positive — Feeling: Poor · 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: Tested positive for COVID-19

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: COVID-19, Dyspnoea, Telemedicine — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Diagnosed with COVID 2 days ago. · Healthcare visit (other): Called doctor to get meds due to trouble breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
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)
2021-01-19
Survey response — day 7, dose 1
MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: COVID-19 positive since Friday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 14, dose 1
MedDRA: COVID-19 pneumonia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: COVID pneumonia

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

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

Adult check-in
2021-02-13
Dose 2 — Moderna
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pneumonia, Pre-existing disease — Feeling: Poor · Site: Pain

Free text: Pneumonia from having COVID resurfaced after shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: COVID-19 pneumonia — Feeling: Poor · Site: Pain

Free text: Pneumonia from Covid is acting up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: COVID-19 pneumonia — Feeling: Poor

Free text: Covid Pneumonia activated by 2nd shot

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: COVID-19 pneumonia — Feeling: Fair

Free text: Slight Covid pneumonia, activated by second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Call 1 — Left Voicemail
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school

Free text: Positive for COVID on12/31/21

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-13	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Took a COVID test - cough, chest congestion, body aches, headache for 4 days

Healthcare visit (other): COVID test at a clinic

2021-01-17

Systemic reaction (other): Tested positive for COVID-19

2021-01-18

Systemic reaction (other): Diagnosed with COVID 2 days ago.

Healthcare visit (other): Called doctor to get meds due to trouble breathing

Release 2 — day 7, dose 1

2021-01-19

Systemic reaction (other): COVID-19 positive since Friday.

Release 2 — day 14, dose 1

2021-01-26

Symptoms: COVID pneumonia

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): Pneumonia from having COVID resurfaced after shot.

2021-02-17

Systemic reaction (other): Pneumonia from Covid is acting up

2021-02-18

Systemic reaction (other): Covid Pneumonia activated by 2nd shot

2021-02-19

Systemic reaction (other): Slight Covid pneumonia, activated by second shot

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Positive for COVID on12/31/21

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	Dyspnoea	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Telemedicine	✓	✓	✓
SD	COVID-19	·	·	✓
SD	COVID-19 pneumonia	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	COVID-19	✓	✓	✓
SRO	COVID-19 pneumonia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pneumonia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	SARS-CoV-2 test	✓	✓	✓
SRO	SARS-CoV-2 test positive	✓	✓	✓

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