3S8-24000-82389

2 vaccinations 10 coded responses 23 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 337 / FL
Registered: 2021-02-04

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Fever · Headache

Free text: feverish overnight broke by 5am (at 17th hr elasped)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Lethargy, Limb discomfort — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: yesterdays post shot discomfort in arm migrated back loins both sides, and generally lethargic today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Discomfort — Feeling: Good · Muscle or body aches

Free text: flank and loin discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Impaired work ability, Self-medication — Feeling: Good · Be unable to work

Free text: Tuesday-Wednesday had headache and tiredness. Felt better by late Wednesday afternoon using Advil. I took Tuesday night off as a licensed machine operator as a precaution.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Peripheral coldness — Feeling: Good

Free text: Slight "chill" feeling in shot arm. Like cold air blowing on it compared to other arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site irritation — Feeling: Good · Site: Swelling

Free text: Slight general irritation in arm that git shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — day 7, dose 2
MedDRA: Dry throat, Pharyngeal swelling — Feeling: Good

Free text: Noticing a slightly swollenness in back of throat, dryness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-27
Survey response — day 21, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Maybe, calfs feeling edema & tightness, may or may not be related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Back pain, Gout, Pre-existing disease — Feeling: Good

Free text: Minor Flare-up of gout, i believe. Very achy lower back/hip joint soreness. But had prior history of back (no hip) condition, so low chance it is related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2022-03-06
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Lethargy — Feeling: Fair

Free text: Lethargy and arthritic joints.

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

Vaccinations

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

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): feverish overnight broke by 5am (at 17th hr elasped)

2021-02-06

Systemic reaction (other): yesterdays post shot discomfort in arm migrated back loins both sides, and generally lethargic today.

2021-02-07

Systemic reaction (other): flank and loin discomfort

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Tuesday-Wednesday had headache and tiredness. Felt better by late Wednesday afternoon using Advil. I took Tuesday night off as a licensed machine operator as a precaution.

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): Slight "chill" feeling in shot arm. Like cold air blowing on it compared to other arm.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Slight general irritation in arm that git shot

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Noticing a slightly swollenness in back of throat, dryness

Release 6 — day 21, dose 2

2021-03-27

Symptoms: Maybe, calfs feeling edema & tightness, may or may not be related

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Minor Flare-up of gout, i believe. Very achy lower back/hip joint soreness. But had prior history of back (no hip) condition, so low chance it is related

Release 11 — 12 months, dose 2

2022-03-06

Symptoms: Lethargy and arthritic joints.

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	Back pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gout	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Impaired work ability	✓	✓	✓
SD	Lethargy	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dry throat	✓	✓	✓
SRO	Injection site irritation	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pharyngeal swelling	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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