3J6-29739-95239

3 vaccinations 10 coded responses 31 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 209 / MD
Registered: 2021-02-05

Relationship: Self
Race: Black or African American
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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: No i have no more symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-19
Survey response — day 14, dose 1
MedDRA: Arthralgia, Headache — Feeling: Fair

Free text: Headache and joining pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Survey response — day 0, dose 2
MedDRA: Atrial fibrillation — Feeling: Good · Site: Swelling · Headache, Nausea

Free text: A fib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Diarrhea

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Joint pains

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Survey response — day 42, dose 2
MedDRA: Arthralgia, Furuncle — Feeling: Fair · Be unable to do your normal daily activities

Free text: Jiont pain and boils unde my arm pjts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Survey response — day 7, dose 3
MedDRA: Pyrexia — Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I got my MODERN BOOSTER SHOTS ON 10-22-21 And I had a FEVER 3 NIGHT . 10-22-23-24 I AM GOOD NOW INSHALLAH!!!!

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 28, dose 3
MedDRA: Vibration syndrome — Feeling: Good

Free text: I am having Vibration in left thigh 10 time or more every day and night.????

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — day 35, dose 3
MedDRA: Paraesthesia — Feeling: Fair

Free text: I having many VIBRATION IN MY LEFT THIGH EVERY DAY AND NIGHT??

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Unevaluable event — Feeling: Good · Be unable to work or attend school

Free text: I had cold or flu last week? But I am good now inshallah!!!!

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-22
Survey response — 12 months, dose 3
MedDRA: Influenza, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: I had the Flu this week or a bad cold.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna
3	2021-10-22	Moderna	No

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): No i have no more symptoms

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): No

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Headache and joining pain

Release 5 — day 0, dose 2

2021-03-05

Systemic reaction (other): A fib

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Jiont pain and boils unde my arm pjts

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): I got my MODERN BOOSTER SHOTS ON 10-22-21 And I had a FEVER 3 NIGHT . 10-22-23-24 I AM GOOD NOW INSHALLAH!!!!

Release 10 — day 28, dose 3

2021-11-19

Symptoms: I am having Vibration in left thigh 10 time or more every day and night.????

Release 10 — day 35, dose 3

2021-11-26

Symptoms: I having many VIBRATION IN MY LEFT THIGH EVERY DAY AND NIGHT??

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: I had cold or flu last week? But I am good now inshallah!!!!

Release 12 — 12 months, dose 3

2022-10-22

Symptoms: I had the Flu this week or a bad cold.

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	Arthralgia	✓	✓	✓
SD	Furuncle	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vibration syndrome	·	·	✓
SRO	Atrial fibrillation	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pyrexia	·	·	✓

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