52M-20106-75337

4 vaccinations 17 coded responses 50 check-ins 17 free-text entries 1 call case

Sex: —
Age at first dose: 66+
ZIP prefix: 349 / FL
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Lightheaded

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

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Arm at side of injection is only slightly tender now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — day 14, dose 1
MedDRA: Dizziness, Fatigue, Lethargy — Feeling: Fair

Free text: Light headed, tired, Lethargic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Woke up witb swollen glands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Sleep disorder, Thirst — Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Free text: Did not sleep well, Thirsty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Vaccination site pain — Feeling: Good · Fatigue or tiredness

Free text: Vaccination site still sore when pushed on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 21, dose 2
MedDRA: Cough, Productive cough, Sinusitis — Feeling: Good

Free text: Sinusitis has been getting worseCough up phlegm often

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Injection site pain, Malaise, Pain, Pyrexia — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to work or attend school

Free text: Prior ToToday it was horrible, chills fever, aches. Iwas given 3dose ,booster Moderna, onthe 25th about 5pm. The 26 and 27 my wife. And I both. Experienced fever, chills, aches and severe pain at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Frequent bowel movements — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Frequent poops

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — day 7, dose 3
MedDRA: Chills, Night sweats — Feeling: Good · Fever · Chills

Free text: Woke up at 2am in a sweat. Did not feel bad just chilled. I did have an alcoholic beverage at dinner

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Ear infection, Medical counselling — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ear infection · Healthcare visit (other): Phone call to ENT prescribed Steroid pack d

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Asthenia, Fatigue — Feeling: Good

Free text: Felt a little punky, a lack of energy. 2 days cleared up. All is pretty good now.

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Dose 4 — Moderna
2022-05-23
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-24
Survey response — days 1–6 daily, dose 4
MedDRA: Chest discomfort, Dizziness, Dyspnoea, Influenza, Insomnia, Mobility decreased, Unevaluable event, Urinary retention — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Tight chest hard to take a deep breathe dizzie 1st report was one hour after injection. Was up all night.also difficulty emptying bladder.. Felt like the "gripp" bad flu as of about 1pm today arm loosened up and no fever or chills.Still a little dizz

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Survey response — days 1–6 daily, dose 4
MedDRA: Feeling abnormal, Hyperhidrosis, Night sweats, Self-medication — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Free text: Second day symtoms are less severe but onset in afternoon. Had to change my shirt in middle of the night dre N ched in sweat. Feeling a little punky now just took ibuprofen around 3:30.

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-27
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Shot site is still tender but I have full range of motion

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Survey response — days 1–6 daily, dose 4
MedDRA: Night sweats — Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Free text: NightShirt. Was wet with perspiration around 2am

MedDRA releases: 2024-11 · check-in free text available
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-21
Survey response — 6 months, dose 4
MedDRA: Cold sweat, Pain, Pain in extremity, Pyrexia, Skin tightness, Vaccine positive rechallenge — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Took my 3 maderna booster last week feverish and clamy for 3 days. Left arm shot extremly sore for 5 days could not lift above head without having pain. Now, its just tight but noticeable. Same symptoms I've had with all covid shots and boosters but

MedDRA releases: 2024-11 · check-in free text available
2023-05-23
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-10-25	Moderna	No
4	2022-05-23	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-03

Systemic reaction (other): Lightheaded

Release 3 — days 1–6 daily, dose 1

2021-02-08

Systemic reaction (other): Arm at side of injection is only slightly tender now

Release 4 — day 14, dose 1

2021-02-17

Symptoms: Light headed, tired, Lethargic

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Woke up witb swollen glands

2021-03-07

Systemic reaction (other): Did not sleep well, Thirsty

2021-03-09

Systemic reaction (other): Vaccination site still sore when pushed on

Release 6 — day 21, dose 2

2021-03-24

Symptoms: Sinusitis has been getting worseCough up phlegm often

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Prior ToToday it was horrible, chills fever, aches. Iwas given 3dose ,booster Moderna, onthe 25th about 5pm. The 26 and 27 my wife. And I both. Experienced fever, chills, aches and severe pain at injection site

2021-10-31

Systemic reaction (other): Frequent poops

Release 10 — day 7, dose 3

2021-11-01

Systemic reaction (other): Woke up at 2am in a sweat. Did not feel bad just chilled. I did have an alcoholic beverage at dinner

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Ear infection

Healthcare visit (other): Phone call to ENT prescribed Steroid pack d

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Felt a little punky, a lack of energy. 2 days cleared up. All is pretty good now.

Release 11 — days 1–6 daily, dose 4

2022-05-24

Systemic reaction (other): Tight chest hard to take a deep breathe dizzie 1st report was one hour after injection. Was up all night.also difficulty emptying bladder.. Felt like the "gripp" bad flu as of about 1pm today arm loosened up and no fever or chills.Still a little dizz cut off by CDC

2022-05-25

Systemic reaction (other): Second day symtoms are less severe but onset in afternoon. Had to change my shirt in middle of the night dre N ched in sweat. Feeling a little punky now just took ibuprofen around 3:30.

2022-05-27

Systemic reaction (other): Shot site is still tender but I have full range of motion

2022-05-28

Systemic reaction (other): NightShirt. Was wet with perspiration around 2am

Release 12 — 6 months, dose 4

2022-11-21

Symptoms: Took my 3 maderna booster last week feverish and clamy for 3 days. Left arm shot extremly sore for 5 days could not lift above head without having pain. Now, its just tight but noticeable. Same symptoms I've had with all covid shots and boosters but cut off by CDC

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	Medical counselling	·	·	✓
SD	Asthenia	·	·	✓
SD	Cold sweat	·	·	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Skin tightness	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Chills	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Frequent bowel movements	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Influenza	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Malaise	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Night sweats	·	·	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Thirst	✓	✓	✓
SRO	Unevaluable event	·	·	✓
SRO	Urinary retention	·	·	✓
SRO	Vaccination site pain	✓	✓	✓

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