3EC-21061-73992

2 vaccinations 11 coded responses 23 check-ins 11 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 660 / KS
Registered: 2021-04-13

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

2021-04-13
Registered in v-safe
2021-04-13
Dose 1 — Moderna
2021-04-13
Survey response — day 0, dose 1
MedDRA: Eye irritation — Feeling: Good

Free text: Slight blurring eye site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Poor · Site: Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Body temperature increased — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Highest temp last night was 99.5

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — day 7, dose 1
Feeling: Fair · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 1
Feeling: Good

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

Adult check-in
2021-05-11
Dose 2 — Moderna
2021-05-11
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye — Feeling: Good · Abdominal pain

Free text: Dry. Eyes since shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-25
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Survey response — day 21, dose 2
MedDRA: Asthenia, Influenza like illness — 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: I have continually had symptoms of flu and lack of any degree of endurance in walking or carry anything in excess of 20!pounds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Survey response — day 28, dose 2
MedDRA: Asthenia, Fatigue, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Increasing fatigue unable to expend much energy. Completely exhausted after minimal exercise. Vo2max decreased by 30% over past months since I had COVID plus shots. · Healthcare visit (other): Doctor visit scheduled

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: I am sure I have sever fatigue as a result of the vaccinations.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Survey response — day 42, dose 2
MedDRA: Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Primarily fatigue and muscle ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-02
Call 1 — Left Voicemail
2021-08-10
Survey response — 3 months, dose 2
MedDRA: Asthenia, Muscle fatigue, Poor quality sleep — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe tiredness in legs, lack of energy and restless sleep.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-11
Survey response — 6 months, dose 2
MedDRA: Balance disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lost considerable balance since second COVID shot. Appears to be progressively worst.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-11	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — day 0, dose 1

2021-04-13

Systemic reaction (other): Slight blurring eye site

Release 7 — days 1–6 daily, dose 1

2021-04-14

Systemic reaction (other): No

2021-04-15

Systemic reaction (other): Highest temp last night was 99.5

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): Sore throat

2021-05-16

Systemic reaction (other): Dry. Eyes since shot

Release 8 — day 21, dose 2

2021-06-01

Symptoms: I have continually had symptoms of flu and lack of any degree of endurance in walking or carry anything in excess of 20!pounds

Release 8 — day 28, dose 2

2021-06-08

Symptoms: Increasing fatigue unable to expend much energy. Completely exhausted after minimal exercise. Vo2max decreased by 30% over past months since I had COVID plus shots.

Healthcare visit (other): Doctor visit scheduled

Release 9 — day 35, dose 2

2021-06-17

Symptoms: I am sure I have sever fatigue as a result of the vaccinations.

Release 9 — day 42, dose 2

2021-06-22

Symptoms: Primarily fatigue and muscle ache

Release 9 — 3 months, dose 2

2021-08-10

Symptoms: Severe tiredness in legs, lack of energy and restless sleep.

Release 10 — 6 months, dose 2

2021-11-11

Symptoms: Lost considerable balance since second COVID shot. Appears to be progressively worst.

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	Balance disorder	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Muscle fatigue	✓	·	✓
SD	Myalgia	✓	✓	✓
SD	Poor quality sleep	✓	·	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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