3EM-26508-96234

4 vaccinations 12 coded responses 23 check-ins 12 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 030 / NH
Registered: 2021-03-06

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

2021-02-06
Dose 1 — Moderna
2021-03-05
Dose 2 — Moderna
2021-03-06
Registered in v-safe
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased, Body temperature normal, Motion sickness — Feeling: Fair · Site: Pain, Redness, Itching · Headache · Be unable to do your normal daily activities

Free text: 99.2 temp, 144/75 BP. Motion sickness 2 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased — Feeling: Good · Site: Pain, Redness, Swelling · Headache · Be unable to do your normal daily activities

Free text: 99.5 temp, 136/76 BP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Productive cough — Feeling: Good · Site: Redness · Headache

Free text: 100 temp, 146/78 BP. coughing, clear pleum

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased, Dizziness — Feeling: Good · Site: Redness · Headache

Free text: 99.2 temp, 136/74 BP. Mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure normal, Body temperature normal — Feeling: Good · Headache

Free text: 99.4 temp, 134/76 BP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Redness · Headache

Free text: 99.1 temp. 132/72 BP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 14, dose 2
MedDRA: Dizziness, Headache, Office visit, Unevaluable event — Feeling: Good · 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: Headache; mostly mild 10 hrs daily, moderate in back area causing dizziness. Use ice water bag on area, lasts about 2 hours. · Healthcare visit (other): NP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Survey response — day 21, dose 2
MedDRA: Dizziness, Headache, Musculoskeletal stiffness, Neck pain — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headaches, mild to severe. Neck area painful and stiff. Dizziness mostly mild occasionally severe. Body temp 99-100, BP 124/66 to 134/78.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Survey response — day 28, dose 2
MedDRA: Blood pressure increased, Dizziness, Headache — Feeling: Good · 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: Headaches, mild to moderate. Mostly mild 5 days. Dizziness, mild some moderate. Take Meclizine (1/2, 25mg) as needed. Body temp 99.8, BP 132/68.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
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)
2021-04-09
Survey response — day 35, dose 2
MedDRA: Dizziness, Headache, Muscle tightness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Neck muscles very tight, in PT 2 x week. Mild headaches on/off. Dizziness is mild, 1 time moderate. Body temp 99.4, BP 126/66. Feeling better 4 days this past week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-10
Call 1 — Left Voicemail
2021-06-10
Call 1 — Left Voicemail
2021-06-10
Call 1 — Left Voicemail
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-04
Dose 3 — Moderna
Co-administered: Flu
2022-03-08
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-05
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-09-28
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-15
Survey response — day 14, dose 4
MedDRA: Cough, Increased upper airway secretion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Coughing excessively, saw Prim Dr, was given other inhaler and refer. I saw Dr (pulmonary), given A/B (5 day course). Feeling better 3 days later. Present; feel better, mild cough w/ less phlegm in throat.

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-17
Call 2 — Left Voicemail
2022-10-17
Call 2 — Left Voicemail
2022-10-17
Call 2 — Left Voicemail
2022-10-17
Call 1 — Left Voicemail
2022-10-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-29
Survey response — 3 months, dose 4
MedDRA: Cough, Dry skin, Headache, Pruritus, Skin disorder, Skin exfoliation — 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: Skin issus; dry, flaky skin that itches. Mild headache from constant coughing.

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-30
Call 3 — Left Voicemail
2022-12-30
Call 3 — Left Voicemail
2022-12-30
Call 3 — Left Voicemail
2022-12-30
Call 2 — Left Voicemail
2022-12-30
Call 1 — Left Voicemail
2023-03-29
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-05	Moderna
3	2021-11-04	Moderna	Flu
4	2022-09-28	Pfizer-BioNTech	Flu

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): 99.2 temp, 144/75 BP. Motion sickness 2 days.

2021-03-08

Systemic reaction (other): 99.5 temp, 136/76 BP.

2021-03-09

Systemic reaction (other): 100 temp, 146/78 BP. coughing, clear pleum

2021-03-10

Systemic reaction (other): 99.2 temp, 136/74 BP. Mild dizziness

2021-03-11

Systemic reaction (other): 99.4 temp, 134/76 BP.

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): 99.1 temp. 132/72 BP.

Release 5 — day 14, dose 2

2021-03-19

Symptoms: Headache; mostly mild 10 hrs daily, moderate in back area causing dizziness. Use ice water bag on area, lasts about 2 hours.

Healthcare visit (other): NP

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Headaches, mild to severe. Neck area painful and stiff. Dizziness mostly mild occasionally severe. Body temp 99-100, BP 124/66 to 134/78.

Release 6 — day 28, dose 2

2021-04-02

Symptoms: Headaches, mild to moderate. Mostly mild 5 days. Dizziness, mild some moderate. Take Meclizine (1/2, 25mg) as needed. Body temp 99.8, BP 132/68.

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Neck muscles very tight, in PT 2 x week. Mild headaches on/off. Dizziness is mild, 1 time moderate. Body temp 99.4, BP 126/66. Feeling better 4 days this past week.

Release 12 — day 14, dose 4

2022-10-15

Symptoms: Coughing excessively, saw Prim Dr, was given other inhaler and refer. I saw Dr (pulmonary), given A/B (5 day course). Feeling better 3 days later. Present; feel better, mild cough w/ less phlegm in throat.

Release 12 — 3 months, dose 4

2022-12-29

Symptoms: Skin issus; dry, flaky skin that itches. Mild headache from constant coughing.

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	Blood pressure increased	✓	✓	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dry skin	·	·	✓
SD	Headache	✓	✓	✓
SD	Increased upper airway secretion	·	·	✓
SD	Muscle tightness	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Skin disorder	·	·	✓
SD	Skin exfoliation	·	·	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Blood pressure normal	✓	✓	✓
SRO	Body temperature normal	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Motion sickness	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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