2UZ-17103-20359

4 vaccinations 7 coded responses 25 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 981 / WA
Registered: 2021-04-18

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-16
Dose 1 — Moderna
2021-04-18
Registered in v-safe
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site erythema, Injection site induration — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hard red painful parallelogram shaped nodule, 3 x 2 near the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Pain — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness

Free text: Red parallelogram spot with aches reduced in color and pain , but still noticeably present and still hard to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-30
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headaches, congestion, sneezing, runny nose, fatigue, insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-14
Dose 2 — Moderna
2021-05-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness · Muscle or body aches

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Feeling abnormal, Genital burning sensation, Headache, Paraesthesia, Peripheral coldness, Pruritus, Skin warm — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: This stuff is crazy! I am fatigued with a splitting headache, my head is swimming, my hands are itching , hot, and pins and needles, my genitals are scotching , and my feet are freezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Throat irritation — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Free text: Itching scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-05-21
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Onfoing fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-18
Survey response — day 35, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ongoing fatigue and joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-11
Dose 3 — Moderna
2022-05-16
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-28
Dose 4 — Moderna
2023-01-11
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2023-06-28
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-16	Moderna
2	2021-05-14	Moderna
3	2022-01-11	Moderna	No
4	2022-12-28	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Systemic reaction (other): Hard red painful parallelogram shaped nodule, 3 x 2 near the injection site

2021-04-20

Systemic reaction (other): Red parallelogram spot with aches reduced in color and pain , but still noticeably present and still hard to the touch

Release 8 — day 14, dose 1

2021-04-30

Symptoms: Headaches, congestion, sneezing, runny nose, fatigue, insomnia

Release 8 — days 1–6 daily, dose 2

2021-05-15

Systemic reaction (other): This stuff is crazy! I am fatigued with a splitting headache, my head is swimming, my hands are itching , hot, and pins and needles, my genitals are scotching , and my feet are freezing.

2021-05-17

Systemic reaction (other): Itching scratchy throat

Release 9 — day 28, dose 2

2021-06-11

Symptoms: Onfoing fatigue

Release 9 — day 35, dose 2

2021-06-18

Symptoms: Ongoing fatigue and joint pain

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	Arthralgia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Genital burning sensation	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site induration	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Skin warm	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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