5BM-24029-65882

4 vaccinations 5 coded responses 25 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 967 / HI
Registered: 2021-03-07

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

2021-01-25
Dose 1 — Moderna
2021-02-22
Dose 2 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 21, dose 2
MedDRA: Dizziness, Dyspnoea, Fatigue, Pain — Feeling: Good

Free text: For 5 days beginning with the 16th day after my second Moderna shot I was really tired with body aches, dizziness and shortness of breath. Following that I have been back to normal for last two days. Never had elevated temp, BP or heart rate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 28, dose 2
MedDRA: Dizziness, Fatigue, Malaise, Myalgia, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: From the 10th to the 14th day, (3/5/21 -3/15/21)AFTER my 2nd Moderna shot on 2/22/21, felt worse than anytime for i dont recall how long, maybe years. No fever but so tired, muscle pain, dizzy, nausea, NO diarrhea. Since 3/16/21 Ive felt GREAT!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — day 35, dose 2
MedDRA: Dizziness, Fatigue, Office visit — Feeling: Poor

Free text: Last three days lightheaded, dizzy spells and tired. 1 week since my cardiologist changed my meds. Stopped HCTZ. That may account for symptoms. No shortness of breath. No fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Survey response — 6 months, dose 2
MedDRA: Medical counselling, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Bad cold after flying to Maui · Healthcare visit (other): Talk with nurse who authorized COVID-19 test at Kaiser Kona clinic. Was tested with negative results.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-29
Dose 3 — Moderna
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-22
Survey response — day 21, dose 3
MedDRA: Fatigue — Feeling: Fair

Free text: Extra tired.

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-18
Dose 4 — Moderna
2022-05-30
Health check-in — day 7, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-06-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-05-21
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-22	Moderna
3	2021-11-29	Moderna	No
4	2022-05-18	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 21, dose 2

2021-03-15

Symptoms: For 5 days beginning with the 16th day after my second Moderna shot I was really tired with body aches, dizziness and shortness of breath. Following that I have been back to normal for last two days. Never had elevated temp, BP or heart rate.

Release 6 — day 28, dose 2

2021-03-22

Symptoms: From the 10th to the 14th day, (3/5/21 -3/15/21)AFTER my 2nd Moderna shot on 2/22/21, felt worse than anytime for i dont recall how long, maybe years. No fever but so tired, muscle pain, dizzy, nausea, NO diarrhea. Since 3/16/21 Ive felt GREAT!

Release 6 — day 35, dose 2

2021-03-29

Symptoms: Last three days lightheaded, dizzy spells and tired. 1 week since my cardiologist changed my meds. Stopped HCTZ. That may account for symptoms. No shortness of breath. No fever.

Release 9 — 6 months, dose 2

2021-08-24

Symptoms: Bad cold after flying to Maui

Healthcare visit (other): Talk with nurse who authorized COVID-19 test at Kaiser Kona clinic. Was tested with negative results.

Release 10 — day 21, dose 3

2021-12-22

Symptoms: Extra tired.

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	SARS-CoV-2 test negative	✓	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasopharyngitis	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓

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