4A9-13974-66779

5 vaccinations 11 coded responses 34 check-ins 9 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 217 / MD
Registered: 2021-01-23

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

Timeline

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

2021-01-21
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good

Free text: Last night, I noted upper arm bruising. Skin color near the injection site is yellow; below that, A small patch of a purple bruise. No pain. No tenderness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — day 7, dose 1
MedDRA: Contusion, Yellow skin — Feeling: Good

Free text: Yellow skin color, about 7 inches in length ending with feeding purple. No pain. No discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No bruising; severe pain yesterday; moderate pain today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 28, dose 2
MedDRA: Abdominal distension, Constipation, Diarrhoea, Gastrointestinal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Five days of constipation and diarrhea. Extreme stomach bloating. Intestinal tract pain. Five days of constipation and diarrhea. Extreme stomach bloating. Intestinal tract pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Intestinal discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-16
Dose 3 — Moderna
2022-02-19
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-18
Dose 4 — Moderna
2022-05-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia — Feeling: Good · Joint pains

Free text: Hip pain unrelated to the injection n

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-05-25
Survey response — day 7, dose 4
MedDRA: Pruritus — Feeling: Good · Joint pains

Free text: Back itch

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-17
Survey response — 3 months, dose 4
MedDRA: Carotid artery occlusion, Carotid revascularisation — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Occluded carotid arteries · Healthcare visit (other): Undergone TCAR surgery in

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-18
Call 3 — Could Not Reach Participant
2022-09-30
Dose 5 — Moderna
Co-administered: Flu
2022-11-16
Survey response — 6 months, dose 4
MedDRA: SARS-CoV-2 test positive, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: On November 7, with a home test, I tested positive for Covid. · Healthcare visit (other): Received an Rx for Paxlovid.

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-17
Call X — Left Voicemail
2022-11-17
Call 3 — Left Voicemail
2023-01-01
Survey response — 3 months, dose 5
MedDRA: Intraocular pressure increased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-01
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-03-31
Survey response — 6 months, dose 5
MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-31
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-03
Call 2 — Left Voicemail
2023-04-03
Call 2 — Left Voicemail
2023-04-03
Call 2 — Left Voicemail
2023-04-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-19	Moderna
3	2021-11-16	Moderna	No
4	2022-05-18	Moderna	No
5	2022-09-30	Moderna	Flu

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Last night, I noted upper arm bruising. Skin color near the injection site is yellow; below that, A small patch of a purple bruise. No pain. No tenderness.

Release 2 — day 7, dose 1

2021-01-28

Systemic reaction (other): Yellow skin color, about 7 inches in length ending with feeding purple. No pain. No discomfort.

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): No bruising; severe pain yesterday; moderate pain today

Release 5 — day 28, dose 2

2021-03-19

Symptoms: Five days of constipation and diarrhea. Extreme stomach bloating. Intestinal tract pain. Five days of constipation and diarrhea. Extreme stomach bloating. Intestinal tract pain.

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Intestinal discomfort

Release 11 — days 1–6 daily, dose 4

2022-05-22

Systemic reaction (other): Hip pain unrelated to the injection n

Release 11 — day 7, dose 4

2022-05-25

Systemic reaction (other): Back itch

Release 12 — 3 months, dose 4

2022-08-17

Symptoms: Occluded carotid arteries

Healthcare visit (other): Undergone TCAR surgery in

Release 12 — 6 months, dose 4

2022-11-16

Symptoms: On November 7, with a home test, I tested positive for Covid.

Healthcare visit (other): Received an Rx for Paxlovid.

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	Carotid revascularisation	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Abdominal distension	✓	✓	✓
SD	Carotid artery occlusion	·	·	✓
SD	Constipation	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Gastrointestinal pain	✓	✓	✓
SD	Intraocular pressure increased	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site discolouration	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Yellow skin	✓	✓	✓

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