3KZ-25084-62933

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 786 / TX
Registered: 2021-03-05

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-04
Dose 1 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-09
Survey response — day 7, dose 2
MedDRA: Paraesthesia, Paraesthesia oral — Feeling: Fair · Fatigue or tiredness

Free text: Mild Nerve tingling on tongue, hands, feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 14, dose 2
MedDRA: Balance disorder, Fatigue, Muscular weakness, Paraesthesia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Pins and needles type Tingling in all ten hand fingers, feet ten fingers. Leg Muscle weakness, poor sense of balance.Sluggish Bowl movement. Overall tired feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 21, dose 2
MedDRA: Neuropathy peripheral — Feeling: Poor · 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: Peripheral Neuropathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
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)
2021-04-30
Survey response — day 28, dose 2
MedDRA: Dysphagia, Dyspnoea, Gait disturbance, Hypoaesthesia, Mobility decreased — Feeling: Poor · Be unable to work, 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: Numbness in extremities, limited ability to walk, difficulty breathing and swallowing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — day 35, dose 2
MedDRA: Guillain-Barre syndrome, Hospitalisation — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Guillain-Barre syndrome · Healthcare visit (other): 2 nights in the hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 35, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — day 42, dose 2
MedDRA: Deep vein thrombosis, Guillain-Barre syndrome — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Gulliane barre syndrome + DVT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Gulliane barre syndrome

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Guillain-Barre syndrome — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Gullian barre syndrome

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-10-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-02	Moderna

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): Mild Nerve tingling on tongue, hands, feet

Release 7 — day 14, dose 2

2021-04-18

Symptoms: Pins and needles type Tingling in all ten hand fingers, feet ten fingers. Leg Muscle weakness, poor sense of balance.Sluggish Bowl movement. Overall tired feeling

Release 7 — day 21, dose 2

2021-04-23

Symptoms: Peripheral Neuropathy

Release 8 — day 28, dose 2

2021-04-30

Symptoms: Numbness in extremities, limited ability to walk, difficulty breathing and swallowing.

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Guillain-Barre syndrome

Healthcare visit (other): 2 nights in the hospital

Release 8 — day 42, dose 2

2021-05-14

Symptoms: Gulliane barre syndrome + DVT

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Gulliane barre syndrome

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Gullian barre syndrome

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	Hospitalisation	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Deep vein thrombosis	✓	✓	✓
SD	Dysphagia	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Guillain-Barre syndrome	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Neuropathy peripheral	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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