49U-22138-97032

4 vaccinations 8 coded responses 31 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 540 / WI
Registered: 2021-04-18

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-17
Dose 1 — Moderna
2021-04-18
Registered in v-safe
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Free text: I have chronic back pain. Its a little worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to work

Free text: Swollen lymph nodes on the side of the injection under my chin. I jave saliva gland problems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymph node swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Lymph nodes swollen left chin/ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-15
Dose 2 — Moderna
2021-05-22
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-05-29
Survey response — day 14, dose 2
MedDRA: Arthralgia, Fatigue, Irritability — Feeling: Fair

Free text: Joint pain, irritability, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-13
Survey response — 6 months, dose 2
MedDRA: Dysphonia, Productive cough — Feeling: Good

Free text: every hour I cough up a small blob of phlegm. occasionally when talking I get hoarse. I have not had these b4 without a cold or flu. I have had this since a month after 2nd shot

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Dose 3 — Moderna
2022-05-15
Survey response — 12 months, dose 2
MedDRA: Fatigue, Headache, Rhinorrhoea, Sneezing — Feeling: Good

Free text: 3 weeks ago, I was sneezing, tired, headaches, and a super runny nose for 4 days. No other symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Dose 4 — Moderna
2022-10-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-31
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-14
Survey response — day 21, dose 4
MedDRA: Fatigue — Feeling: Good

Free text: fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-24
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-17	Moderna
2	2021-05-15	Moderna
3	2022-01-22	Moderna	No
4	2022-10-24	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): I have chronic back pain. Its a little worse

2021-04-19

Systemic reaction (other): Swollen lymph nodes on the side of the injection under my chin. I jave saliva gland problems

2021-04-20

Systemic reaction (other): Lymph node swelling

2021-04-21

Systemic reaction (other): Lymph nodes swollen left chin/ear

Release 8 — day 14, dose 2

2021-05-29

Symptoms: Joint pain, irritability, fatigue

Release 10 — 6 months, dose 2

2021-11-13

Symptoms: every hour I cough up a small blob of phlegm. occasionally when talking I get hoarse. I have not had these b4 without a cold or flu. I have had this since a month after 2nd shot

Release 11 — 12 months, dose 2

2022-05-15

Symptoms: 3 weeks ago, I was sneezing, tired, headaches, and a super runny nose for 4 days. No other symptoms.

Release 12 — day 21, dose 4

2022-11-14

Symptoms: fatigue

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	Dysphonia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Irritability	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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