4PJ-32469-99427

3 vaccinations 5 coded responses 37 check-ins 5 free-text entries 0 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 770 / TX
Registered: 2021-04-16

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-16
Registered in v-safe
2021-04-16
Dose 1 — Moderna
2021-04-16
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Fatigue — Feeling: Good · Site: Pain, Swelling · Be unable to do your normal daily activities

Free text: Fatigue and tiredness with a bit of chill yesterday evening after 1st check-in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-14
Dose 2 — Moderna
2021-05-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth, Eye pain, Hangover — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Pain behind the eyes. Feeling of a hangover. Dry mouth all night. No diarrhea, but multiple stool visits today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-20
Survey response — day 35, dose 2
MedDRA: Injection site pain, Pain — Feeling: Good

Free text: Muscle in left arm has been hurting a bit since the second shot. At first I thought it would go away, but it is persistent. Mostly felt when I lift my arms horizontal to the ground.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Survey response — day 42, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Pain in left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-02
Dose 3 — Moderna
2021-12-02
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-04
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Fever · Chills

Free text: Swelling in left armpit. Mildly painful.

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-16	Moderna
2	2021-05-14	Moderna
3	2021-12-02	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-17

Systemic reaction (other): Fatigue and tiredness with a bit of chill yesterday evening after 1st check-in.

Release 8 — days 1–6 daily, dose 2

2021-05-15

Systemic reaction (other): Pain behind the eyes. Feeling of a hangover. Dry mouth all night. No diarrhea, but multiple stool visits today.

Release 9 — day 35, dose 2

2021-06-20

Symptoms: Muscle in left arm has been hurting a bit since the second shot. At first I thought it would go away, but it is persistent. Mostly felt when I lift my arms horizontal to the ground.

Release 9 — day 42, dose 2

2021-06-28

Symptoms: Pain in left arm.

Release 10 — days 1–6 daily, dose 3

2021-12-04

Systemic reaction (other): Swelling in left armpit. Mildly painful.

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	Injection site pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Chills	✓	·	✓
SRO	Dry mouth	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hangover	✓	✓	✓
SRO	Oedema peripheral	·	·	✓

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