37J-16263-93985

3 vaccinations 10 coded responses 36 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 804 / CO
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Survey response — day 7, dose 1
MedDRA: Fatigue, Feeling abnormal — Feeling: Fair · Chills, Joint pains · Be unable to do your normal daily activities

Free text: Just feel fatigue & off.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-22
Survey response — day 14, dose 1
MedDRA: Fatigue, Respiratory tract congestion, SARS-CoV-2 test — Feeling: Good

Free text: Extreme fatigue & head congestion- went & got a COVID-19 test; waiting on results

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Survey response — day 0, dose 2
MedDRA: Flushing — Feeling: Good · Site: Pain

Free text: Facial flush

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia — Feeling: Good

Free text: Strange metallic taste in my mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia — Feeling: Good

Free text: Strange metallic taste in mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 35, dose 2
MedDRA: Dyspepsia, Nausea, Office visit, Pain in jaw — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Jaw pain, nausea, acid indigestion- went to doctor. EKG normal. Cleared up in two days · Healthcare visit (other): Cardiologist Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-26
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling jittery — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Jittery

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Gingival discomfort, Oral discomfort, Tongue coated — Feeling: Fair · Fatigue or tiredness

Free text: Mouth issues - hard to explain. Tongue, gums, inside cheeks feel coated

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-03
Survey response — day 7, dose 3
MedDRA: Oral disorder — Feeling: Good

Free text: Weird mouth issue - hard to explain

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Asthenia, Headache, Insomnia, Paranasal sinus discomfort — Feeling: Good · Be unable to do your normal daily activities

Free text: Weakness, headache, sinus pressure, insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-10-26	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): Just feel fatigue & off.

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Extreme fatigue & head congestion- went & got a COVID-19 test; waiting on results

Release 3 — day 0, dose 2

2021-02-05

Systemic reaction (other): Facial flush

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Strange metallic taste in my mouth

2021-02-11

Systemic reaction (other): Strange metallic taste in mouth

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Jaw pain, nausea, acid indigestion- went to doctor. EKG normal. Cleared up in two days

Healthcare visit (other): Cardiologist Visit

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Jittery

2021-10-30

Systemic reaction (other): Mouth issues - hard to explain. Tongue, gums, inside cheeks feel coated

Release 10 — day 7, dose 3

2021-11-03

Systemic reaction (other): Weird mouth issue - hard to explain

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Weakness, headache, sinus pressure, insomnia

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	Asthenia	·	·	✓
SD	Dyspepsia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Insomnia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling jittery	·	·	✓
SRO	Flushing	✓	✓	✓
SRO	Gingival discomfort	·	·	✓
SRO	Oral discomfort	·	·	✓
SRO	Oral disorder	·	·	✓
SRO	Tongue coated	·	·	✓

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