4PU-22674-07156

4 vaccinations 21 coded responses 31 check-ins 20 free-text entries 3 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 100 / NY
Registered: 2021-02-28

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

2021-02-28
Registered in v-safe
2021-02-28
Dose 1 — Moderna
2021-02-28
Survey response — day 0, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Sore throat feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Slight sore throat feeling (less than yesterday)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Sore throat feeling is gone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dry throat — Feeling: Good · Site: Pain · Muscle or body aches, Abdominal pain

Free text: Dry throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion — Feeling: Good

Free text: Stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — day 7, dose 1
MedDRA: Dry throat — Feeling: Good

Free text: Dry throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 21, dose 1
MedDRA: Abdominal distension — Feeling: Good

Free text: Bloating (maybe from sugar free candy and gum)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Moderna
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: It's difficult to raise my left arm (arm of the injections) above my head, sense a swelling in my left underarm,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Mobility decreased — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: It's a little easier to lift my left arm above my head than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: A little tightness when raising my left arm over my head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Eye infection — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Eye infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Eye infection — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Eye infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 7, dose 2
MedDRA: Eye infection — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Eye infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 14, dose 2
MedDRA: Eye infection, Nasopharyngitis — Feeling: Good

Free text: Head cold; runny nose; taking medication for eye infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 21, dose 2
MedDRA: Nasal congestion — Feeling: Good

Free text: Stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 35, dose 2
MedDRA: Eye infection, Nasopharyngitis — Feeling: Fair

Free text: Eye infection and head cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 42, dose 2
MedDRA: Gingival discomfort, Toothache — Feeling: Fair

Free text: Toothache and irritated gums

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Survey response — 3 months, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Call 1 — Left Voicemail
2021-07-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-23
Dose 3 — Moderna
2022-04-08
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-31
Survey response — 6 months, dose 3
MedDRA: Blood testosterone decreased — Feeling: Good

Free text: Low testosterone

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Dose 4 — Pfizer-BioNTech
2022-10-14
Survey response — day 14, dose 4
MedDRA: Scleritis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Scleritis

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-10-17
Call 2 — Left Voicemail
2022-10-24
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-02
Survey response — 3 months, dose 4
MedDRA: Eye inflammation — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-01-02
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Moderna
2	2021-04-03	Moderna
3	2021-11-23	Moderna	No
4	2022-09-29	Pfizer-BioNTech	No

Call center

3 call center cases

1 successful · 2 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-28

Systemic reaction (other): Sore throat feeling

Release 4 — days 1–6 daily, dose 1

2021-03-01

Systemic reaction (other): Slight sore throat feeling (less than yesterday)

2021-03-02

Systemic reaction (other): Sore throat feeling is gone

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Dry throat

2021-03-06

Systemic reaction (other): Stuffy nose

Release 5 — day 7, dose 1

2021-03-07

Systemic reaction (other): Dry throat

Release 6 — day 21, dose 1

2021-03-23

Symptoms: Bloating (maybe from sugar free candy and gum)

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): It's difficult to raise my left arm (arm of the injections) above my head, sense a swelling in my left underarm,

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): It's a little easier to lift my left arm above my head than yesterday

2021-04-07

Systemic reaction (other): A little tightness when raising my left arm over my head

2021-04-08

Systemic reaction (other): Eye infection

2021-04-09

Systemic reaction (other): Eye infection

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): Eye infection

Release 7 — day 14, dose 2

2021-04-17

Symptoms: Head cold; runny nose; taking medication for eye infection

Release 8 — day 21, dose 2

2021-04-26

Symptoms: Stuffy nose

Release 8 — day 35, dose 2

2021-05-10

Symptoms: Eye infection and head cold

Release 8 — day 42, dose 2

2021-05-15

Symptoms: Toothache and irritated gums

Release 9 — 3 months, dose 2

2021-07-05

Symptoms: Sore throat

Release 11 — 6 months, dose 3

2022-05-31

Symptoms: Low testosterone

Release 12 — day 14, dose 4

2022-10-14

Symptoms: Scleritis

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	Abdominal distension	✓	✓	✓
SD	Blood testosterone decreased	·	·	✓
SD	Eye infection	✓	✓	✓
SD	Eye inflammation	·	·	✓
SD	Gingival discomfort	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Scleritis	·	·	✓
SD	Toothache	✓	✓	✓
SRO	Dry throat	✓	✓	✓
SRO	Eye infection	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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