596-13028-88485

6 vaccinations 24 coded responses 74 check-ins 23 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 461 / IN
Registered: 2021-01-28

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

2021-01-27
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Flushing — Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Flushed face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-10
Survey response — day 14, dose 1
MedDRA: Dizziness, Fatigue, Headache, Nausea — Feeling: Fair

Free text: Nausea and extreme tiredness throughout the last week. Headaches on and off, but nothing debilitating. Dizziness as well. All these symptoms became less and less towards the end of this week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Nausea

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Chills, Headache, Muscle or body aches, Nausea, Abdominal pain

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-03
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-10
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-17
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Poor

Free text: Bad headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-31
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-07
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair

Free text: Stomach sickness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-10
Dose 3 — Moderna
2021-11-11
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Depression, Sinus pain, Sneezing — Feeling: Poor · Fever · Fatigue or tiredness, Nausea

Free text: Sinus pain. Sneezing. Depression

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — day 7, dose 3
Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-25
Survey response — day 14, dose 3
MedDRA: Dizziness, Fatigue, Nausea — Feeling: Poor

Free text: Dizziness. Nausea. Tiredness

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Survey response — day 21, dose 3
MedDRA: Fatigue — Feeling: Poor

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Survey response — day 28, dose 3
MedDRA: Depression, Fatigue — Feeling: Poor

Free text: Fatigue Depression

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — day 35, dose 3
MedDRA: Depression, Dizziness, Fatigue — Feeling: Poor

Free text: Fatigue. Dizziness. Depression.

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — day 42, dose 3
MedDRA: Abdominal pain upper, Asthenia, Dizziness, Flatulence, Influenza, Nausea, Tremor — Feeling: Poor · Be unable to work or attend school

Free text: Extreme nausea. Weakness. Dizziness. Flatulence. Stomach cramps. Shakiness Might be due to an influenza infection

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Survey response — 3 months, dose 3
MedDRA: Fatigue, Headache, Nausea, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Feeling rundown with headache and fatigue. Stomach nausea due to possible stomach ulcer.

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-17
Call 1 — Could Not Reach Participant
2022-02-23
Call 2 — Could Not Reach Participant
2022-05-11
Survey response — 6 months, dose 3
MedDRA: Fatigue, Nausea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nausea and tiredness · Healthcare visit (other): Doctor's appointment

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

1 call case(s)
2022-05-12
Call 3 — Could Not Reach Participant
2022-05-12
Call 1 — Could Not Reach Participant
2022-05-17
Call 2 — Could Not Reach Participant
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-02
Dose 4 — Moderna
2022-06-02
Survey response — day 0, dose 4
MedDRA: Flatulence — Feeling: Fair

Free text: Flatulence, not related to vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Fatigue — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, extreme fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Diarrhea

Adult check-in
2022-06-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-06-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-06-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2022-06-09
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2022-06-18
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-23
Survey response — day 21, dose 4
MedDRA: Fatigue, Gastrooesophageal reflux disease, Medical counselling, Nausea — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, acid reflux, nausea · Healthcare visit (other): Contacted through health portal

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-24
Call X — Could Not Reach Participant
2022-06-24
Call 3 — Could Not Reach Participant
2022-06-24
Call 1 — Could Not Reach Participant
2022-06-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-30
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-07-07
Survey response — day 35, dose 4
MedDRA: Fatigue, Mood swings, Pyrexia — Feeling: Fair

Free text: Fever. Mood swings. Tiredness

MedDRA releases: 2024-11 · check-in free text available
2022-07-14
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-09-02
Survey response — 3 months, dose 4
MedDRA: Dizziness, Fatigue, Nausea, Pain — Feeling: Poor

Free text: Nausea. Body pains. Tiredness. Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-09-27
Dose 5 — Moderna
2022-09-27
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-04
Health check-in — day 7, dose 5
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-12
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-18
Survey response — day 21, dose 5
MedDRA: Depression, Fatigue, Headache, Mood swings, Paraesthesia — Feeling: Poor

Free text: Headaches. Depression. Tingling brain. Fatigue. Mood swings

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-11-01
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-08
Survey response — day 42, dose 5
MedDRA: Fatigue, Headache — Feeling: Fair

Free text: Headaches. Tiredness

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Survey response — 3 months, dose 5
MedDRA: Asthenia, Dizziness, Fatigue, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Weakness. Dizziness. Nausea. Tiredness.

MedDRA releases: 2024-11 · check-in free text available
2023-03-28
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in
2023-05-03
Dose 6 — Moderna
2023-05-03
Health check-in — day 0, dose 6
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2023-05-04
Health check-in — days 1–6 daily, dose 6
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2023-05-05
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-05-06
Health check-in — days 1–6 daily, dose 6
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2023-05-07
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-05-08
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · None

Adult check-in
2023-05-09
Health check-in — days 1–6 daily, dose 6
Feeling: Good · Fatigue or tiredness

Adult check-in
2023-05-10
Health check-in — day 7, dose 6
Feeling: Fair · Nausea

Adult check-in
2023-05-17
Health check-in — day 14, dose 6
Feeling: Fair

Adult check-in
2023-05-24
Health check-in — day 21, dose 6
Feeling: Fair

Adult check-in
2023-05-31
Health check-in — day 28, dose 6
Feeling: Fair

Adult check-in
2023-06-07
Health check-in — day 35, dose 6
Feeling: Fair

Adult check-in
2023-06-14
Survey response — day 42, dose 6
MedDRA: Depression, Fatigue — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-11-10	Moderna	No
4	2022-06-02	Moderna	No
5	2022-09-27	Moderna	No
6	2023-05-03	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Flushed face

Release 4 — day 14, dose 1

2021-02-10

Symptoms: Nausea and extreme tiredness throughout the last week. Headaches on and off, but nothing debilitating. Dizziness as well. All these symptoms became less and less towards the end of this week.

Release 5 — day 21, dose 2

2021-03-17

Symptoms: Bad headache

Release 7 — day 42, dose 2

2021-04-07

Symptoms: Stomach sickness

Release 10 — days 1–6 daily, dose 3

2021-11-11

Systemic reaction (other): Dizziness

2021-11-14

Systemic reaction (other): Dizziness

2021-11-15

Systemic reaction (other): Sinus pain. Sneezing. Depression

Release 10 — day 14, dose 3

2021-11-25

Symptoms: Dizziness. Nausea. Tiredness

Release 10 — day 21, dose 3

2021-12-01

Symptoms: Fatigue

Release 10 — day 28, dose 3

2021-12-08

Symptoms: Fatigue Depression

Release 10 — day 35, dose 3

2021-12-16

Symptoms: Fatigue. Dizziness. Depression.

Release 10 — day 42, dose 3

2021-12-22

Symptoms: Extreme nausea. Weakness. Dizziness. Flatulence. Stomach cramps. Shakiness Might be due to an influenza infection

Release 11 — 3 months, dose 3

2022-02-11

Symptoms: Feeling rundown with headache and fatigue. Stomach nausea due to possible stomach ulcer.

Release 11 — 6 months, dose 3

2022-05-11

Symptoms: Nausea and tiredness

Healthcare visit (other): Doctor's appointment

Release 11 — day 0, dose 4

2022-06-02

Systemic reaction (other): Flatulence, not related to vaccine

Release 11 — days 1–6 daily, dose 4

2022-06-03

Systemic reaction (other): Dizziness, extreme fatigue

2022-06-04

Systemic reaction (other): Dizziness

Release 12 — day 21, dose 4

2022-06-23

Symptoms: Fatigue, acid reflux, nausea

Healthcare visit (other): Contacted through health portal

Release 12 — day 35, dose 4

2022-07-07

Symptoms: Fever. Mood swings. Tiredness

Release 12 — 3 months, dose 4

2022-09-02

Symptoms: Nausea. Body pains. Tiredness. Dizziness

Release 12 — day 21, dose 5

2022-10-18

Symptoms: Headaches. Depression. Tingling brain. Fatigue. Mood swings

Release 12 — day 42, dose 5

2022-11-08

Symptoms: Headaches. Tiredness

Release 12 — 3 months, dose 5

2022-12-27

Symptoms: Weakness. Dizziness. Nausea. Tiredness.

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	·	·	✓
HCVO	Office visit	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Asthenia	·	·	✓
SD	Depression	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Flatulence	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza	·	·	✓
SD	Mood swings	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pyrexia	·	·	✓
SD	Tremor	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Depression	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Flatulence	·	·	✓
SRO	Flushing	✓	✓	✓
SRO	Sinus pain	·	·	✓
SRO	Sneezing	·	·	✓

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