4NW-30112-02579

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 194 / PA
Registered: 2021-04-05

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

2021-04-05
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Fair · Site: Pain

Free text: I felt extremely cold after supper in warm house. Took tylenol...felt relief a few hours later

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-28
Survey response — day 21, dose 1
MedDRA: Nasal congestion — Feeling: Fair

Free text: Stuffy sinus...smell off and on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Dose 2 — Moderna
2021-05-04
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Diarrhoea — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Seem to relapse last night with intense shivering and woke up to diahrea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-11
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-26
Survey response — day 21, dose 2
MedDRA: Dyspnoea exertional, Peripheral swelling, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus are blocked worse than ever . Have use sinex to breathe easier.Getting out of breath much more when i do things.Feet swelling up more than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — day 28, dose 2
MedDRA: Dyspnoea exertional, Fatigue, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Breathing heavier upon little exertion...pain in neck ...fatigure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Survey response — day 42, dose 2
MedDRA: Fatigue, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Numbness of left side of hand...fatigue...get winded much more · Healthcare visit (other): Went to family dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Call 1 — Could Not Reach Participant
2021-06-30
Call 2 — Left Voicemail
2021-08-03
Survey response — 3 months, dose 2
MedDRA: Amnesia, Dyspnoea — Feeling: Fair

Free text: Memory loss seems increased a lot. Shortness of breath

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-02
Survey response — 6 months, dose 2
MedDRA: Chest pain, Dyspnoea, Fatigue, Musculoskeletal chest pain — Feeling: Poor

Free text: Increased Shortness of breath...fatigued...strange chest pains come and go...hurts to touch

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-04	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): I felt extremely cold after supper in warm house. Took tylenol...felt relief a few hours later

Release 8 — day 21, dose 1

2021-04-28

Symptoms: Stuffy sinus...smell off and on

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Seem to relapse last night with intense shivering and woke up to diahrea

Release 8 — day 21, dose 2

2021-05-26

Symptoms: Sinus are blocked worse than ever . Have use sinex to breathe easier.Getting out of breath much more when i do things.Feet swelling up more than usual

Release 8 — day 28, dose 2

2021-06-01

Symptoms: Breathing heavier upon little exertion...pain in neck ...fatigure

Release 9 — day 42, dose 2

2021-06-17

Symptoms: Numbness of left side of hand...fatigue...get winded much more

Healthcare visit (other): Went to family dr.

Release 9 — 3 months, dose 2

2021-08-03

Symptoms: Memory loss seems increased a lot. Shortness of breath

Release 10 — 6 months, dose 2

2021-11-02

Symptoms: Increased Shortness of breath...fatigued...strange chest pains come and go...hurts to touch

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	✓	✓	✓
SD	Amnesia	✓	·	✓
SD	Chest pain	·	·	✓
SD	Dyspnoea	✓	○	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Paranasal sinus hypersecretion	○	○	○
SD	Peripheral swelling	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Swelling	○	○	○
SRO	Chills	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Feeling cold	✓	✓	✓

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