4T7-17337-69661

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 917 / CA
Registered: 2021-03-24

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

Timeline

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

2021-03-22
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Heart rate 95 to 115

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate normal — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Heart rate about 100

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate abnormal — Feeling: Good

Free text: Heart rate about 100

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Self-medication — Feeling: Good

Free text: Heart rate about 100 and keep taking Aspirin low dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Dose 2 — Moderna
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Headache, Office visit, Thrombosis — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Chest pain and doctor find out has some blood clog · Healthcare visit (other): Family doctor and cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — day 14, dose 2
MedDRA: Thrombosis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Blood clots and did the Angiogram but it's failed. Need the coronary artery bypass surgery.

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

1 call case(s)
2021-05-10
Survey response — day 21, dose 2
MedDRA: Chest pain, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Still have chest pain and waiting for coronary artery bypass operation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-17
Survey response — day 28, dose 2
MedDRA: Chest pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: More frequently have chest pain and waiting for doctor appointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Call 1 — Left Voicemail
2021-07-19
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-19
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): Heart rate 95 to 115

2021-03-26

Systemic reaction (other): Heart rate about 100

2021-03-27

Systemic reaction (other): Heart rate about 100

2021-03-28

Systemic reaction (other): Heart rate about 100 and keep taking Aspirin low dose

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Chest pain and doctor find out has some blood clog

Healthcare visit (other): Family doctor and cardiologist

Release 8 — day 14, dose 2

2021-05-05

Symptoms: Blood clots and did the Angiogram but it's failed. Need the coronary artery bypass surgery.

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Still have chest pain and waiting for coronary artery bypass operation.

Release 8 — day 28, dose 2

2021-05-17

Symptoms: More frequently have chest pain and waiting for doctor appointment.

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	Chest pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Thrombosis	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate abnormal	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Heart rate normal	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Thrombosis	✓	✓	✓

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