3CJ-30784-26269

7 vaccinations 12 coded responses 93 check-ins 12 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 334 / FL
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Survey response — day 0, dose 1
MedDRA: Flushing — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Face feels slightly flushed but only mildly so

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Injection site erythema, Injection site pain, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Redness, swelling, and tenderness at injection site (left deltoid) are gradully improving. Still have considerable fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Injection site erythema, Injection site pain, Injection site swelling — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Redness, swelling, and tenderness in left deltoid injection site area have completely cleared up but still have more than usual fatigue/tiredness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Usually have some level of fatigue/tiredness relate to pre-existing conditions not caused by or related to 1st dose of Moderna covid 19 vaccine. Additional fatigue experienced subsequent to that has abated. Usually require daily naps. Still do.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 7, dose 1
MedDRA: Fatigue, Pre-existing disease, Sleep deficit — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Usually varying amos of fatigue attributable to pre-existing conditions & chronic sleep deprivation tat requires daily naps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · 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 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Dysphonia, Rhinorrhoea, Sneezing, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had what seemed to be a head cold last week. Symptoms included sneezing, runny, nose, hoarseness/scratchy throat but no fever or cough. Gradually resolved in about 5 days.

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

Adult check-in
2021-10-11
Dose 3 — Moderna
2021-10-11
Survey response — day 0, dose 3
MedDRA: Body temperature increased, Chills, Dysphonia, Fatigue, Nasal congestion, Oropharyngeal pain, Pain, Pre-existing disease, Pyrexia, Rhinorrhoea, Upper respiratory tract infection — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: In late June had a URI that included severe nasal congestion, constant runny nose, sore throat, hoarseness, fatigue, achiness, feverish & chills, but body temperature didn't go above 100 degrees farenheit. Symptoms lasted about 5-6 days. (b)(6).

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness · Fatigue or tiredness

Adult check-in
2021-10-18
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness · Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-01
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-08
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-15
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-22
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-10
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-21
Dose 4 — Moderna
2022-02-21
Survey response — day 0, dose 4
MedDRA: Bronchitis, Cough — Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Coughing from cold weather induced of chronic bronchitis.

MedDRA releases: 2024-11 · check-in free text available
2022-02-22
Survey response — days 1–6 daily, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Recuperating from cold weather induced exacerbation of chronic bronchitis. Also have had a flareup of EBV chronic fatigue that might be associated with presumed Delta variant breakthrough infection last year.

MedDRA releases: 2024-11 · check-in free text available
2022-02-23
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Same co-morbidities/pre-existing conditions/symptomptoms as previously reported.

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-28
Survey response — day 7, dose 4
MedDRA: Adverse reaction, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The aforementioned symptoms are likely mostly if not completely associated with preexisting comorbidities and not from the booster (4th) dose of the Moderna vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-03-07
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-03-14
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-03-21
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-03-28
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-04-04
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-05-23
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-07-15
Dose 5 — Moderna
2022-07-15
Health check-in — day 0, dose 5
Feeling: Fair · None

Adult check-in
2022-07-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-19
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-22
Health check-in — day 7, dose 5
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-29
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-08-05
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-08-12
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-08-19
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-08-26
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-09-19
Dose 6 — Pfizer-BioNTech
2022-09-19
Health check-in — day 0, dose 6
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-20
Survey response — days 1–6 daily, dose 6
MedDRA: Adverse reaction, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Current post vaccination rxn similar to previous booster doses.

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-26
Health check-in — day 7, dose 6
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-03
Health check-in — day 14, dose 6
Feeling: Fair

Adult check-in
2022-10-10
Health check-in — day 21, dose 6
Feeling: Fair

Adult check-in
2022-10-17
Health check-in — day 28, dose 6
Feeling: Fair

Adult check-in
2022-10-24
Health check-in — day 35, dose 6
Feeling: Fair

Adult check-in
2022-10-31
Health check-in — day 42, dose 6
Feeling: Fair

Adult check-in
2022-12-19
Health check-in — 3 months, dose 6
Feeling: Fair

Adult check-in
2023-03-20
Health check-in — 6 months, dose 6
Feeling: Fair

Adult check-in
2023-04-24
Dose 7 — Moderna
2023-04-24
Health check-in — day 0, dose 7
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-04-25
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-04-27
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-04-28
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-04-29
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-04-30
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-05-01
Health check-in — day 7, dose 7
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-05-08
Health check-in — day 14, dose 7
Feeling: Fair

Adult check-in
2023-05-15
Health check-in — day 21, dose 7
Feeling: Fair

Adult check-in
2023-05-22
Health check-in — day 28, dose 7
Feeling: Fair

Adult check-in
2023-05-29
Health check-in — day 35, dose 7
Feeling: Fair

Adult check-in
2023-06-05
Health check-in — day 42, dose 7
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-11	Moderna	No
4	2022-02-21	Moderna	No
5	2022-07-15	Moderna	No
6	2022-09-19	Pfizer-BioNTech	No
7	2023-04-24	Moderna	No

Free text

Release 4 — day 0, dose 1

2021-02-12

Systemic reaction (other): Face feels slightly flushed but only mildly so

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): Redness, swelling, and tenderness at injection site (left deltoid) are gradully improving. Still have considerable fatigue.

2021-02-17

Systemic reaction (other): Redness, swelling, and tenderness in left deltoid injection site area have completely cleared up but still have more than usual fatigue/tiredness.

2021-02-18

Systemic reaction (other): Usually have some level of fatigue/tiredness relate to pre-existing conditions not caused by or related to 1st dose of Moderna covid 19 vaccine. Additional fatigue experienced subsequent to that has abated. Usually require daily naps. Still do.

Release 4 — day 7, dose 1

2021-02-19

Systemic reaction (other): Usually varying amos of fatigue attributable to pre-existing conditions & chronic sleep deprivation tat requires daily naps.

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Had what seemed to be a head cold last week. Symptoms included sneezing, runny, nose, hoarseness/scratchy throat but no fever or cough. Gradually resolved in about 5 days.

Release 10 — day 0, dose 3

2021-10-11

Systemic reaction (other): In late June had a URI that included severe nasal congestion, constant runny nose, sore throat, hoarseness, fatigue, achiness, feverish & chills, but body temperature didn't go above 100 degrees farenheit. Symptoms lasted about 5-6 days. (b)(6).

redacted (b)(6)

Release 11 — day 0, dose 4

2022-02-21

Systemic reaction (other): Coughing from cold weather induced of chronic bronchitis.

Release 11 — days 1–6 daily, dose 4

2022-02-22

Systemic reaction (other): Recuperating from cold weather induced exacerbation of chronic bronchitis. Also have had a flareup of EBV chronic fatigue that might be associated with presumed Delta variant breakthrough infection last year.

2022-02-23

Systemic reaction (other): Same co-morbidities/pre-existing conditions/symptomptoms as previously reported.

Release 11 — day 7, dose 4

2022-02-28

Systemic reaction (other): The aforementioned symptoms are likely mostly if not completely associated with preexisting comorbidities and not from the booster (4th) dose of the Moderna vaccine.

Release 12 — days 1–6 daily, dose 6

2022-09-20

Systemic reaction (other): Current post vaccination rxn similar to previous booster doses.

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	Dysphonia	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Bronchitis	·	·	✓
SRO	Chills	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Cough	·	·	✓
SRO	Dysphonia	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sleep deficit	✓	✓	✓
SRO	Upper respiratory tract infection	·	·	✓

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