36B-31121-66472

4 vaccinations 7 coded responses 28 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 850 / AZ
Registered: 2021-03-09

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Survey response — day 21, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Slight sore throat on Saturday. After gargling with salt water, systems resolved in a few hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 28, dose 1
MedDRA: Dry throat — Feeling: Good

Free text: Dry throat, no pain. Common with allergy season for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Dose 2 — Moderna
2021-06-08
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Fatigue, Headache, Neck pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Following the shingles vaccine last month, I expected fatigue, headache and neck pain that I still experience at a mild level.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Dose 3 — Moderna
2022-04-11
Survey response — 12 months, dose 2
MedDRA: Sinusitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Sinus infection treated by 2 different antibiotics.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Dose 4 — Moderna
2022-05-18
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-05-25
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-17
Survey response — day 28, dose 4
MedDRA: Chills, Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat and chills.

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-17
Survey response — 3 months, dose 4
MedDRA: Sinus operation, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had comprehensive sinus surgery. I haven't had any Covid related issues. · Healthcare visit (other): Scheduled sinus surgery

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-18
Call 1 — Left Voicemail
2022-08-18
Call 1 — Left Voicemail
2022-08-18
Call successful
Not applicable - Accidental Reporting
2022-11-16
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-18
Survey response — 12 months, dose 4
MedDRA: Asthenia, Fatigue, Hydrotherapy — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-08	Moderna
3	2021-11-02	Moderna	No
4	2022-05-18	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 21, dose 1

2021-03-30

Symptoms: Slight sore throat on Saturday. After gargling with salt water, systems resolved in a few hours.

Release 7 — day 28, dose 1

2021-04-06

Symptoms: Dry throat, no pain. Common with allergy season for me.

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Following the shingles vaccine last month, I expected fatigue, headache and neck pain that I still experience at a mild level.

Release 11 — 12 months, dose 2

2022-04-11

Symptoms: Sinus infection treated by 2 different antibiotics.

Release 12 — day 28, dose 4

2022-06-17

Symptoms: Sore throat and chills.

Release 12 — 3 months, dose 4

2022-08-17

Symptoms: I had comprehensive sinus surgery. I haven't had any Covid related issues.

Healthcare visit (other): Scheduled sinus surgery

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	Unevaluable event	·	·	✓
SD	Asthenia	·	·	✓
SD	Chills	·	·	✓
SD	Dry throat	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hydrotherapy	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Sinus operation	·	·	✓
SD	Sinusitis	·	·	✓

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