4TX-10820-81995

3 vaccinations 5 coded responses 38 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 900 / CA
Registered: 2021-04-16

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

2021-04-15
Dose 1 — Moderna
2021-04-16
Registered in v-safe
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None · Be unable to do your normal daily activities

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

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-29
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: Good · Be unable to do your normal daily activities

Free text: injection-site swelling, redness, warmth, and slight itchiness. this happened for a day or two after my last check-in and lasted for a little over 72 hrs. things are back to normal the last couple of days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: swollen lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: redness keeps migrating down to my bicep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema — Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: the redness has migrated down from my shoulder to my bicep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — day 7, dose 2
Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-27
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
2021-06-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 3 months, dose 2
Feeling: Fair

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

Adult check-in
2021-11-23
Dose 3 — Moderna
Co-administered: Flu
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · 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
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-30
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-07
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-14
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-21
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-28
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-04
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-24
Survey response — 6 months, dose 3
MedDRA: Condition aggravated, Pre-existing condition improved, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Possible colon issues, more neurological issues that most likely is related to existing neurological condition. · Healthcare visit (other): colonoscopy is scheduled

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-25
Call 1 — Left Voicemail
2022-11-23
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna
3	2021-11-23	Moderna	Flu

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 1

2021-04-29

Symptoms: injection-site swelling, redness, warmth, and slight itchiness. this happened for a day or two after my last check-in and lasted for a little over 72 hrs. things are back to normal the last couple of days.

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): swollen lymph nodes

2021-05-17

Systemic reaction (other): redness keeps migrating down to my bicep.

2021-05-19

Systemic reaction (other): the redness has migrated down from my shoulder to my bicep.

Release 11 — 6 months, dose 3

2022-05-24

Symptoms: Possible colon issues, more neurological issues that most likely is related to existing neurological condition.

Healthcare visit (other): colonoscopy is scheduled

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	Unevaluable event	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Pre-existing condition improved	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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