3DP-11898-75956

2 vaccinations 20 coded responses 22 check-ins 20 free-text entries 9 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 300 / GA
Registered: 2021-03-22

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Moderna
2021-03-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Head discomfort, Nasal congestion — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Blocked nostrils and Pressure on forehead and nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Head discomfort, Paranasal sinus discomfort — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Pressure from the forehead down to the nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Headache — Feeling: Fair · Site: Pain, Itching · Headache, Nausea, Rash, not including the immediate area around the injection site

Free text: Dizziness, pressure in the frontal head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinalgia, Stomatitis — Feeling: Fair · Site: Redness, Itching · Headache, Joint pains, Nausea

Free text: Mouth and nose sores

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Free text: Some dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 14, dose 1
MedDRA: Dizziness, Malaise, Nasal congestion, Nausea, Throat irritation — Feeling: Fair

Free text: Sometimes not feeling well. Nausea. Stuffy nose. Churning stomach. Itchy throat. Occasional dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 21, dose 1
MedDRA: Genital blister, Genital rash, Muscle spasms, Nasal mucosal blistering, Oral mucosal blistering, Oral mucosal eruption, Rash, Throat irritation — Feeling: Fair

Free text: Occasional and steady cramps on my left leg.Rash and blisters in mouth, nose and genitalsItches in the throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 28, dose 1
MedDRA: Malaise, Muscle spasms, Nasal congestion, Rhinalgia, Rhinorrhoea, Stomatitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Mouth and nose sores, leg cramps, occasional stuffy and runny nose, not feeling bodily sometimes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Dose 2 — Moderna
2021-04-26
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling of body temperature change, Hyperhidrosis, Nasal congestion, Rhinorrhoea, Throat irritation — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Feel cold and hot. Sweating while sleeping. Itchy throat. Blocked and runny nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Genital discomfort, Headache, Nasal congestion, Night sweats — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Night sweat, tightening f the chest, severe headaches, blocked nose, genital skin irritation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dizziness, Headache, Oral mucosal eruption, Tongue eruption — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rashes in mouth and tongue. Headache and dizziness, tightening of the chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Chest pain, Dizziness, Glossodynia, Hypersensitivity, Nasal congestion, Oral herpes, Sinus disorder, Unevaluable event — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Tightness and pain in the chest, fever blisters and sores on my tongue, some dizziness, sinus, allergy like running and blocked nose. · Healthcare visit (other): I am yet to schedule with a doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Unevaluable event — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Multiple sores in my tongue, flu-like symptoms. Some dizziness · Healthcare visit (other): Yet to get appointment with the doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Glossodynia, Nasal congestion, Rhinalgia, Rhinorrhoea, Unevaluable event — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sores in the nose and tongue, not feeling too well, some dizziness, runny nose one time and stuffy nose the next, allergy-like feeling · Healthcare visit (other): Yet to see the doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-03
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional

Free text: Have appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-10
Survey response — day 14, dose 2
MedDRA: Headache, Malaise, Pain, Sneezing, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Not feeling too well. Feeling sleepy, some allergies, occasional sneezing and someild headaches. · Healthcare visit (other): Yet to see the doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Chest discomfort, Headache, Influenza like illness, Muscular weakness, Nasal congestion, Unevaluable event — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Symptoms: Not feeling fine, Flu-like symptoms, Escalated blood pressure, Weakness in the legs and arms, Blocked nose, occasional tightening of the chest. Some headache. · Healthcare visit (other): Scheduled appointment with the doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 21, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-26
Survey response — day 28, dose 2
MedDRA: Malaise, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Occasionally not feeling well and some funny symptoms · Healthcare visit (other): Doctor's visit scheduled.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Survey response — day 42, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shape pain on the right of my back behind my stomach.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Hypogeusia, Nasal congestion, Office visit, Pain, Rhinorrhoea — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: General body aches and pains. Some loss of taste. Running nos e and stuffy nose.All these symptoms started since after I got the vaccines. · Healthcare visit (other): Seeing my personal physician.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-26	Moderna

Call center

9 call center cases

9 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Blocked nostrils and Pressure on forehead and nose

2021-03-24

Systemic reaction (other): Pressure from the forehead down to the nose

2021-03-26

Systemic reaction (other): Dizziness, pressure in the frontal head

2021-03-27

Systemic reaction (other): Mouth and nose sores

Release 6 — day 7, dose 1

2021-03-30

Systemic reaction (other): Some dizziness

Release 7 — day 14, dose 1

2021-04-06

Symptoms: Sometimes not feeling well. Nausea. Stuffy nose. Churning stomach. Itchy throat. Occasional dizziness.

Release 7 — day 21, dose 1

2021-04-13

Symptoms: Occasional and steady cramps on my left leg.Rash and blisters in mouth, nose and genitalsItches in the throat.

Release 7 — day 28, dose 1

2021-04-21

Symptoms: Mouth and nose sores, leg cramps, occasional stuffy and runny nose, not feeling bodily sometimes.

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): Feel cold and hot. Sweating while sleeping. Itchy throat. Blocked and runny nose.

2021-04-28

Systemic reaction (other): Night sweat, tightening f the chest, severe headaches, blocked nose, genital skin irritation.

2021-04-29

Systemic reaction (other): Rashes in mouth and tongue. Headache and dizziness, tightening of the chest

2021-04-30

Systemic reaction (other): Tightness and pain in the chest, fever blisters and sores on my tongue, some dizziness, sinus, allergy like running and blocked nose.

Healthcare visit (other): I am yet to schedule with a doctor

2021-05-01

Systemic reaction (other): Multiple sores in my tongue, flu-like symptoms. Some dizziness

Healthcare visit (other): Yet to get appointment with the doctor.

2021-05-02

Systemic reaction (other): Sores in the nose and tongue, not feeling too well, some dizziness, runny nose one time and stuffy nose the next, allergy-like feeling

Healthcare visit (other): Yet to see the doctor

Release 8 — day 7, dose 2

2021-05-03

Healthcare visit (other): Have appointment

Release 8 — day 14, dose 2

2021-05-10

Symptoms: Not feeling too well. Feeling sleepy, some allergies, occasional sneezing and someild headaches.

Healthcare visit (other): Yet to see the doctor

Release 8 — day 21, dose 2

2021-05-18

Symptoms: Not feeling fine, Flu-like symptoms, Escalated blood pressure, Weakness in the legs and arms, Blocked nose, occasional tightening of the chest. Some headache.

Healthcare visit (other): Scheduled appointment with the doctor.

Release 8 — day 28, dose 2

2021-05-26

Symptoms: Occasionally not feeling well and some funny symptoms

Healthcare visit (other): Doctor's visit scheduled.

Release 9 — day 42, dose 2

2021-06-09

Symptoms: Shape pain on the right of my back behind my stomach.

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: General body aches and pains. Some loss of taste. Running nos e and stuffy nose.All these symptoms started since after I got the vaccines.

Healthcare visit (other): Seeing my personal physician.

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	Abdominal pain upper	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Genital blister	✓	✓	✓
SD	Genital rash	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypogeusia	✓	·	✓
SD	Influenza like illness	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasal mucosal blistering	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oral mucosal blistering	✓	✓	✓
SD	Oral mucosal eruption	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rhinalgia	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Stomatitis	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling of body temperature change	✓	✓	✓
SRO	Genital discomfort	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Oral mucosal eruption	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Rhinalgia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Stomatitis	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Tongue eruption	✓	✓	✓

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