58E-30973-28615

3 vaccinations 14 coded responses 18 check-ins 14 free-text entries 9 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 787 / TX
Registered: 2021-02-14

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

2021-02-04
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Anxiety, Decreased appetite, Insomnia, Poor peripheral circulation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: High anxiety. Difficulty sleeping even with anti anxiety medicine. Significantly decreased appetite. Poor circulation in feet in a room about 70 degrees.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — day 21, dose 1
MedDRA: Decreased appetite, Lethargy, Mood swings, Pharyngeal swelling, Restlessness, Self-medication, Wheezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Mood swings, night time restlessness, lethargy during the day, throat swelling (controllable by Benadryl), significantly reduced appetite, wheezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Dose 2 — Moderna
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Mental disorder, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · 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

Free text: Exacerbation of anxiety and mental health issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — days 1–6 daily, 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)
2021-03-12
Survey response — day 7, dose 2
MedDRA: Blood pressure fluctuation, Body temperature fluctuation — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Temperature and blood pressure fluctuations. Negative impact on psychiatry meds effectiveness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-21
Survey response — day 14, dose 2
MedDRA: Anxiety, Depression, Dysphagia, Mouth swelling, Somnolence, Swollen tongue — 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

Free text: Depression, anxiety, swollen mouth/tongue, difficulty swallowing and sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
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)
2021-04-02
Survey response — day 28, dose 2
MedDRA: Insomnia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-17
Survey response — day 42, dose 2
MedDRA: Blood pressure fluctuation, Brain fog, Hypertension, Insomnia, Weight fluctuation — 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

Free text: Higher than normal blood pressure. Blood pressure crashes and spikes. Fluctuating weight. Difficulty sleeping. Brain fog.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 42, 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)
2021-06-05
Survey response — 3 months, dose 2
MedDRA: Asthma, Cough, Hypersensitivity, Pre-existing disease, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Exacerbated allergies and asthma. More coughing and wheezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-29
Dose 3 — Moderna
2021-11-30
Survey response — days 1–6 daily, dose 3
MedDRA: Condition aggravated, Confusional state, Insomnia, Psychomotor hyperactivity — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Hyperactivity (made ADHD worse); insomnia; mild confusion; exacerbated chronic nerve pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-14
Survey response — day 14, dose 3
MedDRA: Hypersensitivity, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat. Extra sensitivity to allergens and smells.

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Survey response — day 21, dose 3
MedDRA: Insomnia, Pharyngeal swelling — Feeling: Fair

Free text: Throat swelling. Difficulty sleeping (much more than usual).

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — day 28, dose 3
MedDRA: Dizziness, Insomnia, Respiratory tract congestion — Feeling: Fair

Free text: Congestion, dizziness, insomnia. L

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Survey response — day 35, dose 3
MedDRA: Cough, Dysphagia, Insomnia, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sneezing, runny nose, congestion, difficulty swallowing, insomnia, coughing

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-11
Survey response — day 42, dose 3
MedDRA: Nasal congestion, Self-medication, Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Extreme nasal and sinus congestion that doesn't improve with OTC medications

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-12
Call 1 — Could Not Reach Participant
2022-01-17
Call 2 — Could Not Reach Participant
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-05	Moderna
3	2021-11-29	Moderna	No

Call center

9 call center cases

8 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-18

Symptoms: High anxiety. Difficulty sleeping even with anti anxiety medicine. Significantly decreased appetite. Poor circulation in feet in a room about 70 degrees.

Release 4 — day 21, dose 1

2021-02-27

Symptoms: Mood swings, night time restlessness, lethargy during the day, throat swelling (controllable by Benadryl), significantly reduced appetite, wheezing

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Exacerbation of anxiety and mental health issues

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Temperature and blood pressure fluctuations. Negative impact on psychiatry meds effectiveness.

Release 6 — day 14, dose 2

2021-03-21

Symptoms: Depression, anxiety, swollen mouth/tongue, difficulty swallowing and sleeping

Release 6 — day 28, dose 2

2021-04-02

Symptoms: Insomnia

Release 7 — day 42, dose 2

2021-04-17

Symptoms: Higher than normal blood pressure. Blood pressure crashes and spikes. Fluctuating weight. Difficulty sleeping. Brain fog.

Release 8 — 3 months, dose 2

2021-06-05

Symptoms: Exacerbated allergies and asthma. More coughing and wheezing.

Release 10 — days 1–6 daily, dose 3

2021-11-30

Systemic reaction (other): Hyperactivity (made ADHD worse); insomnia; mild confusion; exacerbated chronic nerve pain

Release 10 — day 14, dose 3

2021-12-14

Symptoms: Sore throat. Extra sensitivity to allergens and smells.

Release 10 — day 21, dose 3

2021-12-21

Symptoms: Throat swelling. Difficulty sleeping (much more than usual).

Release 10 — day 28, dose 3

2021-12-31

Symptoms: Congestion, dizziness, insomnia. L

Release 10 — day 35, dose 3

2022-01-03

Symptoms: Sneezing, runny nose, congestion, difficulty swallowing, insomnia, coughing

Release 10 — day 42, dose 3

2022-01-11

Symptoms: Extreme nasal and sinus congestion that doesn't improve with OTC medications

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	Anxiety	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dysphagia	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Mood swings	✓	✓	✓
SD	Mouth swelling	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pharyngeal swelling	✓	✓	✓
SD	Poor peripheral circulation	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Restlessness	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Sneezing	·	·	✓
SD	Somnolence	✓	✓	✓
SD	Swollen tongue	✓	✓	✓
SD	Weight fluctuation	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Blood pressure fluctuation	✓	✓	✓
SRO	Body temperature fluctuation	✓	✓	✓
SRO	Condition aggravated	·	·	✓
SRO	Confusional state	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Mental disorder	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Psychomotor hyperactivity	·	·	✓

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