4L6-12735-48072

3 vaccinations 8 coded responses 29 check-ins 7 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 329 / FL
Registered: 2021-03-15

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Muscle or body aches

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye — Feeling: Good · Site: Pain

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — day 7, dose 2
MedDRA: Dry eye — Feeling: Good · Fatigue or tiredness

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good · Be unable to work or attend school, 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: Head, throat, and chest congestion for the past 3 weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-22
Call 1 — Left Voicemail
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Fatigue, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I tested positive for Covid-19 on Aug 2. I had fever for 2 days that peaked at 101.5 F. Also had throat and chest congestion for a week, significant fatigue for a month.

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Dose 3 — Moderna
2022-04-12
Survey response — 12 months, dose 2
MedDRA: Anosmia, Fatigue, Insomnia, Post-acute COVID-19 syndrome, Pre-existing disease, Upper-airway cough syndrome — Feeling: Fair

Free text: Post nasal drip when fatigued. Intermittent loss of sense of smell. Difficulty sleeping at night due to post nasal drip. I beleive these symptoms are long covid related. I had covid in August 2021.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-18
Survey response — 6 months, dose 3
MedDRA: Anosmia, Pre-existing disease — Feeling: Good

Free text: Chronic post nasal drip when fatigued, intermittent loss of smell.

MedDRA releases: 2024-11 · check-in free text available
2023-01-17
Survey response — 12 months, dose 3
MedDRA: Atrial fibrillation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-01-17
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-01-18
Call successful
Not applicable - Accidental Reporting
2023-01-18
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2022-01-17	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): None

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Dry eyes

Release 7 — day 7, dose 2

2021-04-19

Systemic reaction (other): Dry eyes

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: Head, throat, and chest congestion for the past 3 weeks.

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: I tested positive for Covid-19 on Aug 2. I had fever for 2 days that peaked at 101.5 F. Also had throat and chest congestion for a week, significant fatigue for a month.

Release 11 — 12 months, dose 2

2022-04-12

Symptoms: Post nasal drip when fatigued. Intermittent loss of sense of smell. Difficulty sleeping at night due to post nasal drip. I beleive these symptoms are long covid related. I had covid in August 2021.

Release 12 — 6 months, dose 3

2022-07-18

Symptoms: Chronic post nasal drip when fatigued, intermittent loss of smell.

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	Anosmia	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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