395-14687-11947

4 vaccinations 10 coded responses 32 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 379 / TN
Registered: 2021-03-19

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

2021-03-18
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Feeling abnormal — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, no nausea with it. Decided to stay in bed the afternoon to avoid falling. Also brain fog, more than usual. I do have a mild traumatic brain injury. Happened in 2001 & affects my daily life, but this is on top of that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness without nausea, same as yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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 — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-21
Survey response — day 35, dose 2
MedDRA: Dizziness, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Nausea on Sunday & Tuesday. Some dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Injection site pain, Pain, Unevaluable event — Feeling: Good

Free text: The past 2 or 3 days, the muscle in the area of the injection, it's sore, like painful sores tr. When I lift my arm that specific site felt like a needle all over again. Today it's the entire muscle, same as before.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Dose 3 — Moderna
2022-04-23
Survey response — 12 months, dose 2
MedDRA: Diabetic wound, Impaired healing, Injection site mass, Injection site pain, Office visit, Pre-existing disease — Feeling: Fair · 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: Symptoms: Non-healing diabetic wound. (Saw wound clinic.) I had a sometimes painful lump (large diffuse) at the injection site for months. I didn't see a doctor about it, it was intermittent pain & I knew it would go away. · Healthcare visit (other): Wound care clinic

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-26
Call 2 — Left Voicemail
2022-10-02
Dose 4 — Moderna
2022-10-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-10-13
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-16
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-07
Survey response — day 35, dose 4
MedDRA: Back pain, Diarrhoea, Dizziness, Nausea, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Probably not related, but my back is in extreme pain re: caretaking & I already have serious back issues. I've also been feeling queasy & lightheaded. Loose stools bordering on diarrhea. · Healthcare visit (other): Had appt already scheduled w/pain Dr. May need to go back.

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-08
Call 3 — Left Voicemail
2022-11-08
Call 2 — Left Voicemail
2022-11-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-02
Survey response — 3 months, dose 4
MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-02
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-04-04
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-16	Moderna
3	2021-11-24	Moderna	No
4	2022-10-02	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Dizziness, no nausea with it. Decided to stay in bed the afternoon to avoid falling. Also brain fog, more than usual. I do have a mild traumatic brain injury. Happened in 2001 & affects my daily life, but this is on top of that.

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Dizziness without nausea, same as yesterday.

Release 7 — day 0, dose 2

2021-04-16

Systemic reaction (other): Dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Dizziness

2021-04-18

Systemic reaction (other): Dizziness

Release 8 — day 35, dose 2

2021-05-21

Symptoms: Nausea on Sunday & Tuesday. Some dizziness.

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: The past 2 or 3 days, the muscle in the area of the injection, it's sore, like painful sores tr. When I lift my arm that specific site felt like a needle all over again. Today it's the entire muscle, same as before.

Release 11 — 12 months, dose 2

2022-04-23

Symptoms: Non-healing diabetic wound. (Saw wound clinic.) I had a sometimes painful lump (large diffuse) at the injection site for months. I didn't see a doctor about it, it was intermittent pain & I knew it would go away.

Healthcare visit (other): Wound care clinic

Release 12 — day 35, dose 4

2022-11-07

Symptoms: Probably not related, but my back is in extreme pain re: caretaking & I already have serious back issues. I've also been feeling queasy & lightheaded. Loose stools bordering on diarrhea.

Healthcare visit (other): Had appt already scheduled w/pain Dr. May need to go back.

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Back pain	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Diabetic wound	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Impaired healing	·	·	✓
SD	Injection site mass	·	·	✓
SD	Injection site pain	·	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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