3S4-29028-09783

3 vaccinations 9 coded responses 28 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 344 / FL
Registered: 2021-01-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Myalgia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Muscle pain is on my arm only

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold, Pre-existing disease — Feeling: Good · Fever · Chills, Fatigue or tiredness

Free text: I feel cold in my body. Will restart exercise today. I am a type 2 diabetic. Thank you

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling · Be unable to do your normal daily activities

Free text: Swelling of the lymph nodes in my neck under my jaw

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Muscle or body aches

Free text: Minor swelling of my lymph nodes under my jaw. Less than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Call the 24 hr. Nurse and my doctor to find how to reduce fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Report sent to call center — days 1–6 daily, 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)
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Absent, irritable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Free text: Irritable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Tiredness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Dose 3 — Moderna
2021-11-30
Survey response — 3 months, dose 3
MedDRA: Chest pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Chest pain. Started about 1 month after the third shot. It went away about 2 months after the third shot (Moderna). · Healthcare visit (other): Doctor's office

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-01
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-01	Moderna
3	2021-08-31	Moderna	No

Call center

3 call center cases

2 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-06

Systemic reaction (other): Muscle pain is on my arm only

2021-01-07

Systemic reaction (other): I feel cold in my body. Will restart exercise today. I am a type 2 diabetic. Thank you

2021-01-09

Systemic reaction (other): Swelling of the lymph nodes in my neck under my jaw

2021-01-10

Systemic reaction (other): Minor swelling of my lymph nodes under my jaw. Less than yesterday

Release 3 — days 1–6 daily, dose 2

2021-02-02

Healthcare visit (other): Call the 24 hr. Nurse and my doctor to find how to reduce fever

2021-02-03

Systemic reaction (other): Absent, irritable.

2021-02-07

Systemic reaction (other): Irritable

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Tiredness

Release 10 — 3 months, dose 3

2021-11-30

Symptoms: Chest pain. Started about 1 month after the third shot. It went away about 2 months after the third shot (Moderna).

Healthcare visit (other): Doctor's office

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Pyrexia	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Fatigue	✓	·	✓
SRO	Feeling cold	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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