4JH-33653-63126

2 vaccinations 9 coded responses 19 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 956 / CA
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-13
Survey response — day 21, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Tenderness — Feeling: Fair

Free text: Injection site is light red, very itchy and sore to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Dose 2 — Moderna
2021-02-18
Survey response — day 0, dose 2
MedDRA: Injection site pruritus — Feeling: Good · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Quite annoying itchiness at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breathe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breathe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 7, dose 2
MedDRA: Fatigue, Oedema peripheral, Poor quality sleep — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Leg edema; fatigue with inability to sleep well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 14, dose 2
MedDRA: Cardiac operation, Myocardial infarction — Feeling: Good · Be unable to work

Free text: Suffered myocardial infarction - in for open heart Sx tomorrow 03/06/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 21, dose 2
MedDRA: Hospitalisation, Myocardial infarction — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Suffered heart attack 02/28/21 - spent 8 days in hospital. Doing well now. Ta

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Myocardial infarction, Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Myocardial infarction on March 03. Still undergoing heart related treatment and tests. Otherwise, fairly good! · Healthcare visit (other): On going VA cardiac treatment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Dyspnoea, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Persistent weak breathing. I use a CPAC machine at night but now I seem to need it during the day ( I dont however).

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-20
Call 1 — Left Voicemail
2022-01-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-18
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-18	Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 21, dose 1

2021-02-13

Symptoms: Injection site is light red, very itchy and sore to the touch

Release 4 — day 0, dose 2

2021-02-18

Systemic reaction (other): Quite annoying itchiness at injection site

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): Shortness of breathe

2021-02-23

Systemic reaction (other): Shortness of breathe

Release 4 — day 7, dose 2

2021-02-25

Systemic reaction (other): Leg edema; fatigue with inability to sleep well

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Suffered myocardial infarction - in for open heart Sx tomorrow 03/06/21

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Suffered heart attack 02/28/21 - spent 8 days in hospital. Doing well now. Ta

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Myocardial infarction on March 03. Still undergoing heart related treatment and tests. Otherwise, fairly good!

Healthcare visit (other): On going VA cardiac treatment.

Release 9 — 6 months, dose 2

2021-08-19

Symptoms: Persistent weak breathing. I use a CPAC machine at night but now I seem to need it during the day ( I dont however).

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	✓	·	✓
HCVO	Unevaluable event	○	✓	○
SD	Cardiac operation	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Dyspnoea	✓	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Myocardial infarction	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Tenderness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓

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