43A-95909-96485

1 vaccination 8 coded responses 9 check-ins 8 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 113 / NY
Registered: 2021-04-08

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-04-06
Dose 1 — Moderna
2021-04-08
Registered in v-safe
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Heart rate increased, Sinus pain — Feeling: Poor · Abdominal pain

Free text: Accelerated heartbeat, feeling of a rush in my head, pain the forehead and sinuses

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling hot, Head discomfort — Feeling: Fair · Headache

Free text: Head feels clogged ar times. Arms feel warm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: Stuffy forehead.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Head discomfort, Paranasal sinus discomfort — Feeling: Poor · Headache, Nausea

Free text: Feeling a rush into my head that comes and goes and is unbearable. Pressure on my forehead and sinuses. Clogged and foggy mind

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 1
MedDRA: Feeling abnormal, Head discomfort, Respiratory tract congestion, Taste disorder — Feeling: Fair · Headache

Free text: Feeling of a rush in my head and a nasty, medicinal taste in my mouth, clogged head and weird feeling in my forehead

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 1
MedDRA: Malaise — Feeling: Poor

Free text: General malaise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 28, dose 1
MedDRA: Abdominal distension, Abdominal pain upper, Brain fog, Dysgeusia, Headache, Neuralgia — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headaches, foggy head, bad taste in my mouth, bloated and painful stomachs specially after eating. Nerve pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Survey response — day 42, dose 1
MedDRA: Arthralgia, Brain fog, Head discomfort, Joint stiffness, Myositis, Nervous system disorder, Office visit, Restlessness — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Severe neurological problems, a feeling of a rush to the head, severe muscle inflammation and tightness in the legs, joint pain, feeling of an unending restless, occasional brain fog. I dont feel like my old safe. The vaccine did something to me. · Healthcare visit (other): In person visits to specialists

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 42, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-08

Systemic reaction (other): Accelerated heartbeat, feeling of a rush in my head, pain the forehead and sinuses

2021-04-10

Systemic reaction (other): Head feels clogged ar times. Arms feel warm

2021-04-11

Systemic reaction (other): Stuffy forehead.

2021-04-12

Systemic reaction (other): Feeling a rush into my head that comes and goes and is unbearable. Pressure on my forehead and sinuses. Clogged and foggy mind

Release 7 — day 7, dose 1

2021-04-13

Systemic reaction (other): Feeling of a rush in my head and a nasty, medicinal taste in my mouth, clogged head and weird feeling in my forehead

Release 8 — day 21, dose 1

2021-04-27

Symptoms: General malaise

Release 8 — day 28, dose 1

2021-05-06

Symptoms: Headaches, foggy head, bad taste in my mouth, bloated and painful stomachs specially after eating. Nerve pain.

Release 8 — day 42, dose 1

2021-05-18

Symptoms: Severe neurological problems, a feeling of a rush to the head, severe muscle inflammation and tightness in the legs, joint pain, feeling of an unending restless, occasional brain fog. I dont feel like my old safe. The vaccine did something to me.

Healthcare visit (other): In person visits to specialists

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	Abdominal distension	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Joint stiffness	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Myositis	✓	✓	✓
SD	Nervous system disorder	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Restlessness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Taste disorder	✓	✓	✓

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