33P-13707-77029

2 vaccinations 15 coded responses 25 check-ins 15 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 577 / SD
Registered: 2021-03-13

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

2021-03-12
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Headache

Free text: I hate COVID19

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-02
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Fair

Free text: Trouble with headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Dose 2 — Moderna
2021-04-09
Survey response — day 0, dose 2
MedDRA: Adverse reaction — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I believe my symptoms are from the 1st injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Sinuses hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Depression — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Depression, anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia, Feeling abnormal — Feeling: Good · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog hasnt been getting better, & I can't taste very much

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 7, dose 2
MedDRA: Hypoglycaemia — Feeling: Poor · Chills, Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Hypoglycemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 14, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have been having bouts with hyperglycemia. I will be fine & then I have to eat. My blood sugar goes down really fast. Something is making my diabetes go up and down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 35, dose 2
MedDRA: Blood glucose decreased, Diabetes mellitus, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: I am diabetic and my Blood glucose dropped way low

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-11
Survey response — 3 months, dose 2
MedDRA: Dysgeusia, Taste disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: All foods go from tasting the way I remember and like. Now, alot of foods either taste bad or no taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Taste disorder — Feeling: Fair

Free text: I rarely taste my food

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Survey response — 12 months, dose 2
MedDRA: Diabetes mellitus, Disturbance in attention — Feeling: Poor

Free text: Hard to cocentrate, Diabetes seems more difficult to control

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): No

2021-03-14

Systemic reaction (other): None

2021-03-17

Systemic reaction (other): I hate COVID19

Release 6 — day 21, dose 1

2021-04-02

Symptoms: Trouble with headaches

Release 7 — day 0, dose 2

2021-04-09

Systemic reaction (other): I believe my symptoms are from the 1st injection

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Sinuses hurt

2021-04-11

Systemic reaction (other): No

2021-04-13

Systemic reaction (other): Depression, anxiety

2021-04-15

Systemic reaction (other): Brain fog hasnt been getting better, & I can't taste very much

Release 7 — day 7, dose 2

2021-04-16

Systemic reaction (other): Hypoglycemia

Release 7 — day 14, dose 2

2021-04-23

Symptoms: I have been having bouts with hyperglycemia. I will be fine & then I have to eat. My blood sugar goes down really fast. Something is making my diabetes go up and down

Release 8 — day 35, dose 2

2021-05-14

Symptoms: I am diabetic and my Blood glucose dropped way low

Release 9 — 3 months, dose 2

2021-07-11

Symptoms: All foods go from tasting the way I remember and like. Now, alot of foods either taste bad or no taste

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: I rarely taste my food

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: Hard to cocentrate, Diabetes seems more difficult to control

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	Blood glucose decreased	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Diabetes mellitus	✓	✓	✓
SD	Disturbance in attention	·	·	✓
SD	Dysgeusia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Taste disorder	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypoglycaemia	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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