2ZR-16989-78750

5 vaccinations 9 coded responses 54 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 066 / CT
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersensitivity, Nasopharyngitis — Feeling: Fair

Free text: Headvold/allergy symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Nasopharyngitis — Feeling: Good

Free text: Unrelated headcold believe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Injection site soreness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 28, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Soreness around injection area returned/pronounced again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Have a head cold.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Moderna
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-26
Survey response — day 28, dose 3
MedDRA: Cough, Headache, Nasopharyngitis, Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, cold, headache and sorethroat

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-12-31
Survey response — day 35, dose 3
MedDRA: Cough, Lower respiratory tract infection, Nasopharyngitis, Office visit, Oropharyngeal pain, Respiratory tract congestion, Upper-airway cough syndrome — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still have ahead & slight chest cold, post nasal drip, congestion, sorethroat and cough. · Healthcare visit (other): Saw my PCP

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-07
Survey response — day 42, dose 3
MedDRA: Cough, Lower respiratory tract infection, Nasopharyngitis, Oropharyngeal pain, Sinus congestion — Feeling: Fair

Free text: Still have a head & chest cold. Sinus congestion with slight cough and sore throat. I don't believe it is connected to the booster shot.

MedDRA releases: 2024-11 · check-in free text available
2022-02-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Dose 4 — Moderna
2022-05-19
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2022-05-19
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-05
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Dose 5 — Moderna
2022-10-01
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Soreness at injection site

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-07
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-14
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-21
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-28
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-11
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-30
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-01	Moderna
3	2021-11-26	Moderna	No
4	2022-05-06	Moderna	No
5	2022-09-30	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Headvold/allergy symptoms

2021-03-08

Systemic reaction (other): Unrelated headcold believe

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Injection site soreness

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Soreness around injection area returned/pronounced again

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Have a head cold.

Release 10 — day 28, dose 3

2021-12-26

Symptoms: Cough, cold, headache and sorethroat

Release 10 — day 35, dose 3

2021-12-31

Symptoms: Still have ahead & slight chest cold, post nasal drip, congestion, sorethroat and cough.

Healthcare visit (other): Saw my PCP

Release 10 — day 42, dose 3

2022-01-07

Symptoms: Still have a head & chest cold. Sinus congestion with slight cough and sore throat. I don't believe it is connected to the booster shot.

Release 12 — days 1–6 daily, dose 5

2022-10-01

Systemic reaction (other): Soreness at injection site

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	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓

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