485-25931-92199

5 vaccinations 18 coded responses 65 check-ins 18 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 303 / GA
Registered: 2021-03-11

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
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
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: insomnia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Headache

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 14, dose 2
MedDRA: Asthenia, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: pretty severe nausea. weakness. neither as bad as after first dose, but debilitating nonetheless. much better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 21, dose 2
MedDRA: Disorientation, Fatigue, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: bad nausea/disorientation and extreme fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — day 28, dose 2
MedDRA: Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 35, dose 2
MedDRA: Feeding disorder, Food aversion, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: nausea. better today but for past several days so bad that i found it hard to eat; the. very thought of food made the nausea worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 42, dose 2
MedDRA: Anxiety, Headache, Malaise, Nausea, Oropharyngeal pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: headache, nausea, general malaise, mild sore throat past couple of nights, increased anxiety (im bipolar if that helps) the nausea will abate but any mild stress will cause it to return. some days worse than others.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-02
Dose 3 — Moderna
2021-11-02
Survey response — day 0, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: nope

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Paranasal sinus discomfort — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: dizziness and sinus pressure. also feel totally checked out. pretty much consistent with first two doses but can't understand why my reactions are so severe. hopefully, it doesn't last weeks like the other two.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Survey response — day 21, dose 3
MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Survey response — day 28, dose 3
MedDRA: Anxiety, Bipolar disorder, Decreased appetite, Dissociation, Insomnia, Muscle rigidity, Muscle spasms, Pre-existing disease, Weight decreased — Feeling: Fair · Be unable to do your normal daily activities

Free text: muscle rigidity in both legs, severe leg cramp a couple of night ago, inability to sleep, loss of appetite and concurrent weight loss. feeling slightly disconnected and hypo-manic (i'm bipolar. so not a full episode of mania). anxiety attacks.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — day 35, dose 3
MedDRA: Anxiety, Diarrhoea, Malaise — Feeling: Good · Be unable to do your normal daily activities

Free text: diarrhea and general malaise. increased anxiety.

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-03
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-06-01
Dose 4 — Moderna
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Fever · Muscle or body aches

Adult check-in
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-06-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-08
Health check-in — day 7, dose 4
Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-06-15
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-22
Survey response — day 21, dose 4
MedDRA: Abdominal discomfort — Feeling: Poor · Be unable to do your normal daily activities

Free text: currently experiencing extreme stomach discomfort, but i don't think it's related to vaccine, but felt it important to report nonetheless as it could be.

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Survey response — day 28, dose 4
MedDRA: Appetite disorder, Diarrhoea, Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: extreme exhaustion. inconsistent appetite. diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-13
Survey response — day 42, dose 4
MedDRA: Depression, Diarrhoea, Fatigue, Nausea, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: nausea diarrhea congestion exhaustion depression

MedDRA releases: 2024-11 · check-in free text available
2022-09-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-26
Dose 5 — Moderna
2022-09-26
Survey response — day 0, dose 5
MedDRA: Malaise, Pain, Pre-existing disease, Reaction to previous exposure to any vaccine — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: dealing with another severe pain issue unrelated to this vaccine, but honestly, this shot has caused me the least grief of all of them at this point. my not feeling well is not due to the vaccine, but no option for concurrent illness

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Report sent to call center — day 0, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-09-28
Call 1 — Left Voicemail
2022-09-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-02
Survey response — days 1–6 daily, dose 5
MedDRA: Chest discomfort, Sensation of foreign body, Throat tightness — Feeling: Fair

Free text: throat/chest tightness. hard to explain but essentially feels like trying to swallow a pill that gets lodged in the throat. abating now, but lasted several hours today.

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-10
Survey response — day 14, dose 5
MedDRA: Asthenia, Chills, Diarrhoea, Injection site rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: low energy, chills, diarrhea rash near injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Survey response — day 21, dose 5
MedDRA: Abnormal loss of weight, Anxiety, Brain fog, Decreased appetite, Depression, Diarrhoea, Fluid retention, Insomnia — Feeling: Fair · Be unable to do your normal daily activities

Free text: increased anxiety, diarrhea, brain fog, depression, insomnia, lack of appetite, water retention in legs followed by rapid weight loss.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-07
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-26
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-27
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-11-02	Moderna	No
4	2022-06-01	Moderna	No
5	2022-09-26	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): insomnia.

Release 7 — day 14, dose 2

2021-04-22

Symptoms: pretty severe nausea. weakness. neither as bad as after first dose, but debilitating nonetheless. much better now.

Release 8 — day 21, dose 2

2021-04-29

Symptoms: bad nausea/disorientation and extreme fatigue.

Release 8 — day 28, dose 2

2021-05-08

Symptoms: nausea

Release 8 — day 35, dose 2

2021-05-13

Symptoms: nausea. better today but for past several days so bad that i found it hard to eat; the. very thought of food made the nausea worse

Release 8 — day 42, dose 2

2021-05-20

Symptoms: headache, nausea, general malaise, mild sore throat past couple of nights, increased anxiety (im bipolar if that helps) the nausea will abate but any mild stress will cause it to return. some days worse than others.

Release 10 — day 0, dose 3

2021-11-02

Systemic reaction (other): nope

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): dizziness and sinus pressure. also feel totally checked out. pretty much consistent with first two doses but can't understand why my reactions are so severe. hopefully, it doesn't last weeks like the other two.

Release 10 — day 21, dose 3

2021-11-23

Symptoms: diarrhea

Release 10 — day 28, dose 3

2021-11-30

Symptoms: muscle rigidity in both legs, severe leg cramp a couple of night ago, inability to sleep, loss of appetite and concurrent weight loss. feeling slightly disconnected and hypo-manic (i'm bipolar. so not a full episode of mania). anxiety attacks.

Release 10 — day 35, dose 3

2021-12-07

Symptoms: diarrhea and general malaise. increased anxiety.

Release 12 — day 21, dose 4

2022-06-22

Symptoms: currently experiencing extreme stomach discomfort, but i don't think it's related to vaccine, but felt it important to report nonetheless as it could be.

Release 12 — day 28, dose 4

2022-06-29

Symptoms: extreme exhaustion. inconsistent appetite. diarrhea.

Release 12 — day 42, dose 4

2022-07-13

Symptoms: nausea diarrhea congestion exhaustion depression

Release 12 — day 0, dose 5

2022-09-26

Systemic reaction (other): dealing with another severe pain issue unrelated to this vaccine, but honestly, this shot has caused me the least grief of all of them at this point. my not feeling well is not due to the vaccine, but no option for concurrent illness

Release 12 — days 1–6 daily, dose 5

2022-10-02

Systemic reaction (other): throat/chest tightness. hard to explain but essentially feels like trying to swallow a pill that gets lodged in the throat. abating now, but lasted several hours today.

Release 12 — day 14, dose 5

2022-10-10

Symptoms: low energy, chills, diarrhea rash near injection site.

Release 12 — day 21, dose 5

2022-10-17

Symptoms: increased anxiety, diarrhea, brain fog, depression, insomnia, lack of appetite, water retention in legs followed by rapid weight loss.

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 discomfort	·	·	✓
SD	Abnormal loss of weight	·	·	✓
SD	Anxiety	✓	✓	✓
SD	Appetite disorder	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Bipolar disorder	·	·	✓
SD	Brain fog	·	·	✓
SD	Chills	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Depression	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Disorientation	✓	✓	✓
SD	Dissociation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeding disorder	✓	✓	✓
SD	Fluid retention	·	·	✓
SD	Food aversion	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site rash	·	·	✓
SD	Insomnia	·	·	✓
SD	Malaise	✓	✓	✓
SD	Muscle rigidity	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Malaise	·	·	✓
SRO	No adverse event	·	·	✓
SRO	Pain	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Sensation of foreign body	·	·	✓
SRO	Throat tightness	·	·	✓

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