32K-30826-35569

3 vaccinations 11 coded responses 36 check-ins 11 free-text entries 2 call cases

Sex: Male
Age at first dose: 21-25
ZIP prefix: 959 / CA
Registered: 2021-03-20

Relationship: Self
Race: N/A
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-21
Dose 2 — Moderna
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-28
Survey response — day 7, dose 2
MedDRA: Emergency care, Office visit, Unevaluable event — Feeling: Fair · Fever · Chills, Headache, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Systemic reaction (other): These may or may not be due to something else im dealing with currently. (Had a possible reaction to certain meds or it could be allergy related, currently trying to see my doctors about it). · Healthcare visit (other): Went to my local walk in clinic and ER on the afternoon and night of 4/27. Currently trying to visit my Primary Care Provider about what has happened over the last few days. (To be clear the visit was on 4/27/21)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Back pain, Neuralgia, Pre-existing disease, Productive cough, SARS-CoV-2 test negative, Sinus congestion — Feeling: Good

Free text: More phlegmy and "clogged" sinuses due to the cold weather changes. I have tested 2 times for covid with those symptoms and came back negative. I also developed back/nerve pain but could be due to poor posture/pinched nerve from months ago.

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Dose 3 — Moderna
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Balance disorder, Dizziness, Poor quality sleep, Vertigo — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness, but it could be due to lack of quality sleep or vertigo/equilibrium issues (i used to listen to music through one ear for a long time in highschool)

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Headache, Hypertension — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Headache/dizziness could be from high blood pressure, just found out about having it with an at home blood pressure cuff

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Hypertension — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: High blood pressure, have not taken medication as per doctors instructions (to take when needed and discontinue if issue has been suppressed enough, which has since come back and am on 10mg propranolol

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — days 1–6 daily, dose 3
MedDRA: Nerve compression — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Have a pinched nerve from early this year with several locations with occasional arm, back, and rib pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Survey response — day 7, dose 3
MedDRA: Hypertension, Nerve compression, Neuralgia, Pre-existing disease, Vertigo — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Same health conditions as before, pinched nerve/nerve pain, high BP, vertigo

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-12
Survey response — day 21, dose 3
MedDRA: Blood pressure increased — Feeling: Fair

Free text: Dont know if it can be related to vaccine or just my own health in general, but i have had an uptick in high blood pressure (ive gotten readings between 130/85 - 150/90 with my normal blood pressure usually within the 120-130 range

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Survey response — day 28, dose 3
MedDRA: Blood pressure abnormal — Feeling: Fair

Free text: Just blood pressure, not sure if due to lifestyle/stress/anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — day 35, dose 3
MedDRA: Gastrointestinal disorder, Palpitations — Feeling: Fair

Free text: Unsure what it could be, have not been to the doctor for it but ive been feeling stomach/gastrointestinal issues going on for about a week, as well as the occasional palpitations that seem to be more frequent

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-10
Call 1 — Left Voicemail
2022-02-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-22
Survey response — 6 months, dose 3
MedDRA: Pilonidal disease, Surgery — Feeling: Fair · Be unable to work or attend school, 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: Pilonidal cyst, did have surgery to get it removed and am recovering. Still going to be a while before the wound heals.

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-23
Call 2 — Left Voicemail
2022-05-23
Call 1 — Left Voicemail
2022-11-21
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-21	Moderna
3	2021-11-21	Moderna	No

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): These may or may not be due to something else im dealing with currently. (Had a possible reaction to certain meds or it could be allergy related, currently trying to see my doctors about it).

Healthcare visit (other): Went to my local walk in clinic and ER on the afternoon and night of 4/27. Currently trying to visit my Primary Care Provider about what has happened over the last few days. (To be clear the visit was on 4/27/21)

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: More phlegmy and "clogged" sinuses due to the cold weather changes. I have tested 2 times for covid with those symptoms and came back negative. I also developed back/nerve pain but could be due to poor posture/pinched nerve from months ago.

Release 10 — days 1–6 daily, dose 3

2021-11-24

Systemic reaction (other): Dizziness, but it could be due to lack of quality sleep or vertigo/equilibrium issues (i used to listen to music through one ear for a long time in highschool)

2021-11-25

Systemic reaction (other): Headache/dizziness could be from high blood pressure, just found out about having it with an at home blood pressure cuff

2021-11-26

Systemic reaction (other): High blood pressure, have not taken medication as per doctors instructions (to take when needed and discontinue if issue has been suppressed enough, which has since come back and am on 10mg propranolol

2021-11-27

Systemic reaction (other): Have a pinched nerve from early this year with several locations with occasional arm, back, and rib pain

Release 10 — day 7, dose 3

2021-11-28

Systemic reaction (other): Same health conditions as before, pinched nerve/nerve pain, high BP, vertigo

Release 10 — day 21, dose 3

2021-12-12

Symptoms: Dont know if it can be related to vaccine or just my own health in general, but i have had an uptick in high blood pressure (ive gotten readings between 130/85 - 150/90 with my normal blood pressure usually within the 120-130 range

Release 10 — day 28, dose 3

2021-12-19

Symptoms: Just blood pressure, not sure if due to lifestyle/stress/anxiety

Release 10 — day 35, dose 3

2021-12-26

Symptoms: Unsure what it could be, have not been to the doctor for it but ive been feeling stomach/gastrointestinal issues going on for about a week, as well as the occasional palpitations that seem to be more frequent

Release 11 — 6 months, dose 3

2022-05-22

Symptoms: Pilonidal cyst, did have surgery to get it removed and am recovering. Still going to be a while before the wound heals.

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	Emergency care	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Back pain	·	·	✓
SD	Blood pressure abnormal	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Neuralgia	·	·	✓
SD	Palpitations	·	·	✓
SD	Pilonidal disease	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Surgery	·	·	✓
SRO	Balance disorder	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Headache	·	·	✓
SRO	Hypertension	·	·	✓
SRO	Nerve compression	·	·	✓
SRO	Neuralgia	·	·	✓
SRO	Poor quality sleep	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vertigo	·	·	✓

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