3LU-18603-94684

4 vaccinations 7 coded responses 35 check-ins 7 free-text entries 3 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 891 / NV
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-14
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-16
Survey response — 3 months, dose 2
MedDRA: Chills, Night sweats, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe Chills for 20 minutes & Sweats for 1 night · Healthcare visit (other): Dr Office Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-15
Survey response — 6 months, dose 2
MedDRA: Fatigue, Gait disturbance, Hyperhidrosis, Mobility decreased, Night sweats, Office visit, Pain in extremity, Somnolence — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lot of pain under right thigh, getting hard to step up/walk. Night sweats, pillow & bed soaked overnight. Also sweating during the day but not as much as overnight. Also tired. Sleepy 8 hours into the day (didnt have this before). · Healthcare visit (other): Office visits

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-15
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

1 call case(s)
2021-08-18
Call 1 — Left Voicemail
2021-08-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-29
Dose 3 — Moderna
Co-administered: Flu
2021-10-24
Survey response — day 21, dose 3
MedDRA: Oropharyngeal pain, Sleep disorder — Feeling: Fair

Free text: Sore throat since injections. Rough sleep.

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-03
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-10
Survey response — day 42, dose 3
MedDRA: Fatigue, Myalgia, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat, fatigue & upper thigh muscle pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-01
Survey response — 6 months, dose 3
MedDRA: Brain fog, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sleep during day, in a fog.

MedDRA releases: 2024-11 · check-in free text available
2022-09-15
Dose 4 — Moderna
2022-09-26
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-10-01
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-06
Survey response — day 21, dose 4
MedDRA: Impaired healing, Office visit, Ulcer — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Not healing. Sores opening & not healing despite being on antibiotics. · Healthcare visit (other): Dr.'s office visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-13
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-20
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-10-27
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-17
Survey response — 3 months, dose 4
MedDRA: Brain fog, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activities

Free text: Brain Fog cannot be productive.

MedDRA releases: 2024-11 · check-in free text available
2023-03-16
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-14	Moderna
3	2021-09-29	Moderna	Flu
4	2022-09-15	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 8 — 3 months, dose 2

2021-05-16

Symptoms: Severe Chills for 20 minutes & Sweats for 1 night

Healthcare visit (other): Dr Office Visit

Release 9 — 6 months, dose 2

2021-08-15

Symptoms: Lot of pain under right thigh, getting hard to step up/walk. Night sweats, pillow & bed soaked overnight. Also sweating during the day but not as much as overnight. Also tired. Sleepy 8 hours into the day (didnt have this before).

Healthcare visit (other): Office visits

Release 10 — day 21, dose 3

2021-10-24

Symptoms: Sore throat since injections. Rough sleep.

Release 10 — day 42, dose 3

2021-11-10

Symptoms: Sore throat, fatigue & upper thigh muscle pain

Release 11 — 6 months, dose 3

2022-04-01

Symptoms: Sleep during day, in a fog.

Release 12 — day 21, dose 4

2022-10-06

Symptoms: Not healing. Sores opening & not healing despite being on antibiotics.

Healthcare visit (other): Dr.'s office visit

Release 12 — 3 months, dose 4

2022-12-17

Symptoms: Brain Fog cannot be productive.

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	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chills	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Gait disturbance	✓	·	✓
SD	Hyperhidrosis	✓	·	✓
SD	Impaired healing	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Mobility decreased	✓	·	✓
SD	Myalgia	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	·	✓
SD	Sleep disorder	·	·	✓
SD	Somnolence	✓	·	✓
SD	Ulcer	·	·	✓

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