4LD-28945-75009

4 vaccinations 10 coded responses 24 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 947 / CA
Registered: 2021-03-03

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

2021-02-02
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 28, dose 2
MedDRA: Sensitive skin — Feeling: Good

Free text: Sensitive to sunlight? Face sun burnt and right hand sun burnt...sitting in shade near the (b)(6) for about 1.5 hrs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 35, dose 2
MedDRA: Pain — Feeling: Good

Free text: Soreness caused by a car accident!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Sneezing, Vertigo — Feeling: Good

Free text: Came off my Afib meds. A little vertigo. Tend to sneeze more.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-15
Dose 3 — Moderna
2022-04-19
Dose 4 — Moderna
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-03
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-10
Survey response — day 21, dose 4
MedDRA: Cough, Poor quality sleep — Feeling: Fair

Free text: Coughing, restless sleep

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Survey response — day 28, dose 4
MedDRA: Diarrhoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Survey response — day 35, dose 4
MedDRA: Blood pressure abnormal, Heart rate abnormal, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Change in heart medication and changes in heart rate and blood pressure.

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Survey response — day 42, dose 4
MedDRA: Asthenia, Blood pressure increased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lack of energy, elevated blood pressure needing new meds.

MedDRA releases: 2024-11 · check-in free text available
2022-07-20
Survey response — 3 months, dose 4
MedDRA: Hospitalisation, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Positive test result for Covid and being hospitalized.

MedDRA releases: 2024-11 · check-in free text available
2022-07-20
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-07-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-18
Survey response — 6 months, dose 4
MedDRA: COVID-19, Hospitalisation — 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

Free text: July caught Covid and was hospitalized.

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Report sent to call center — 6 months, dose 4
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 · 1 call case(s)
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-19
Survey response — 12 months, dose 4
MedDRA: Gout — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-03	Moderna
3	2021-11-15	Moderna	No
4	2022-04-19	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 28, dose 2

2021-03-31

Symptoms: Sensitive to sunlight? Face sun burnt and right hand sun burnt...sitting in shade near the (b)(6) for about 1.5 hrs.

redacted (b)(6)

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Soreness caused by a car accident!

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: Came off my Afib meds. A little vertigo. Tend to sneeze more.

Release 11 — day 21, dose 4

2022-05-10

Symptoms: Coughing, restless sleep

Release 11 — day 28, dose 4

2022-05-17

Symptoms: Diarrhea, fatigue

Release 11 — day 35, dose 4

2022-05-25

Symptoms: Change in heart medication and changes in heart rate and blood pressure.

Release 11 — day 42, dose 4

2022-05-31

Symptoms: Lack of energy, elevated blood pressure needing new meds.

Release 12 — 3 months, dose 4

2022-07-20

Symptoms: Positive test result for Covid and being hospitalized.

Release 12 — 6 months, dose 4

2022-10-18

Symptoms: July caught Covid and was hospitalized.

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	Asthenia	·	·	✓
SD	Blood pressure abnormal	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gout	·	·	✓
SD	Heart rate abnormal	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Pain	✓	✓	✓
SD	Poor quality sleep	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sensitive skin	✓	✓	✓
SD	Sneezing	✓	·	✓
SD	Vertigo	✓	·	✓

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