4QX-83225-68630

4 vaccinations 11 coded responses 36 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 761 / TX
Registered: 2021-01-15

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Survey response — day 14, dose 1
MedDRA: Body temperature increased — Feeling: Good

Free text: I was running a slight temp with a high of 100.5 for 1 night only...I did take 1 instant and 1 saliva based test 1 day apart when that happened with a negative test result on each

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Sensation of foreign body — Feeling: Fair · Site: Pain

Free text: Feel like a lump in my throat but can breathe ok just very annoying and send like a little upper chest pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 21, dose 2
MedDRA: Ear infection, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Sinus and inner ear infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 35, dose 2
MedDRA: Diverticulitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Diverticulitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 42, dose 2
MedDRA: Diverticulitis, Gastrooesophageal reflux disease — Feeling: Fair

Free text: Diverticulitis and GERD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Diverticulitis, Nephrolithiasis, Sinusitis — Feeling: Good · 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: Diverticulitis, kidney stones, sinus infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-14
Survey response — 6 months, dose 2
MedDRA: Abdominal pain — Feeling: Good

Free text: Random pains in abdomen area on both sides,

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-12
Call 1 — Left Voicemail
2022-05-21
Dose 3 — Moderna
2022-11-01
Dose 4 — Moderna
2022-11-01
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Chills, Headache, 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
2022-11-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-04
Survey response — days 1–6 daily, dose 4
MedDRA: Feeling of body temperature change — Feeling: Fair · Be unable to do your normal daily activities

Free text: Since last night I have been feeling hot cold then hot cold again... When is expected I feel hot I'm trying to AC on to like 72 and then I finally feel like it cool down and then it repeats itself

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-08
Survey response — day 35, dose 4
MedDRA: Pharyngeal disorder — Feeling: Fair

Free text: Throat issues

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Survey response — day 42, dose 4
MedDRA: Tonsillar hypertrophy — Feeling: Fair

Free text: Swollen tonsils

MedDRA releases: 2024-11 · check-in free text available
2023-02-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-08
Survey response — 6 months, dose 4
MedDRA: Tinnitus — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna
3	2022-05-21	Moderna	No
4	2022-11-01	Moderna	No

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 14, dose 1

2021-01-29

Symptoms: I was running a slight temp with a high of 100.5 for 1 night only...I did take 1 instant and 1 saliva based test 1 day apart when that happened with a negative test result on each

Release 4 — days 1–6 daily, dose 2

2021-02-15

Systemic reaction (other): Feel like a lump in my throat but can breathe ok just very annoying and send like a little upper chest pressure

Release 5 — day 21, dose 2

2021-03-05

Symptoms: Sinus and inner ear infection

Release 5 — day 35, dose 2

2021-03-19

Symptoms: Diverticulitis

Release 6 — day 42, dose 2

2021-03-26

Symptoms: Diverticulitis and GERD

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: Diverticulitis, kidney stones, sinus infection

Release 9 — 6 months, dose 2

2021-08-14

Symptoms: Random pains in abdomen area on both sides,

Release 12 — days 1–6 daily, dose 4

2022-11-04

Systemic reaction (other): Since last night I have been feeling hot cold then hot cold again... When is expected I feel hot I'm trying to AC on to like 72 and then I finally feel like it cool down and then it repeats itself

Release 12 — day 35, dose 4

2022-12-08

Symptoms: Throat issues

Release 12 — day 42, dose 4

2022-12-13

Symptoms: Swollen tonsils

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 pain	✓	·	✓
SD	Body temperature increased	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Nephrolithiasis	✓	✓	✓
SD	Pharyngeal disorder	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Tinnitus	·	·	✓
SD	Tonsillar hypertrophy	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Feeling of body temperature change	·	·	✓
SRO	Sensation of foreign body	✓	✓	✓

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