3RK-35933-32387

2 vaccinations 7 coded responses 20 check-ins 7 free-text entries 1 call case

Sex: Male
Age at first dose: 26-30
ZIP prefix: 129 / NY
Registered: 2021-03-18

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-03-17
Dose 1 — Moderna
2021-03-18
Registered in v-safe
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Diarrhea

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Acne — Feeling: Good

Free text: Breaking out in pimples, Ive never done that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 7, dose 1
MedDRA: Acne, Cyst — Feeling: Good

Free text: Breaking out in pimples and cysts...this is not normal for me. I have never had pimples before now, nor cysts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 14, dose 1
MedDRA: Rash — Feeling: Good

Free text: Rash development all over body, especially on right arm, not injection site arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Fair · Site: Itching · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Cough, Nausea, Oropharyngeal pain, Pyrexia — Feeling: Poor · Be unable to work

Free text: Cough, sore throat, nausea, fever and stomach pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Survey response — day 42, dose 2
MedDRA: Apathy, Fatigue — Feeling: Fair

Free text: Tired, all the time. Motivation is gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Anxiety, Diarrhoea — Feeling: Fair · Be unable to work or attend school

Free text: Still have diarrhea and increased anxiety.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — 12 months, dose 2
MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: I tested positive for Covid around three weeks ago.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-04-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Breaking out in pimples, Ive never done that.

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Breaking out in pimples and cysts...this is not normal for me. I have never had pimples before now, nor cysts.

Release 6 — day 14, dose 1

2021-03-31

Symptoms: Rash development all over body, especially on right arm, not injection site arm.

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Cough, sore throat, nausea, fever and stomach pain.

Release 8 — day 42, dose 2

2021-05-26

Symptoms: Tired, all the time. Motivation is gone.

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Still have diarrhea and increased anxiety.

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: I tested positive for Covid around three weeks ago.

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	Abdominal pain upper	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Apathy	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Acne	✓	✓	✓
SRO	Cyst	✓	✓	✓

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