5C7-22930-67764

5 vaccinations 12 coded responses 56 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 61-65
ZIP prefix: 231 / VA
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Survey response — day 0, dose 1
MedDRA: Blood glucose abnormal, Diabetes mellitus, Pre-existing disease — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Blood sugar swings of 40 - 80 points. Type II diabetic.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Blood sugar has been running higher than usual. Body not responding to insulin injections as usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose fluctuation — Feeling: Good · Muscle or body aches

Free text: Blood Sugar still bouncing more than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose abnormal — Feeling: Good · Muscle or body aches

Free text: Blood sugar less erratic than the last two days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Moderate fatigue on late 8th and most of 9th day post vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Survey response — day 0, dose 2
MedDRA: Dehydration — Feeling: Good · Site: Itching

Free text: Dehydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Blood Sugar running 30 points above normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Lack of appetite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased — Feeling: Good · Diarrhea

Free text: Blood sugar 25 points above normal readings.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Short of breath but may be allergy related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Survey response — 6 months, dose 2
MedDRA: Cataract operation — Feeling: Good

Free text: Cataract surgery on right eye.

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Dose 3 — Moderna
Co-administered: Flu
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-06
Dose 4 — Moderna
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-05
Survey response — 6 months, dose 4
MedDRA: Lower respiratory tract infection, Office visit, Sinus disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fall sinus and chest cold. · Healthcare visit (other): PCP

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-30
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-31
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-06
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-13
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-04
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-11
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-31
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-30
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-09	Moderna
3	2021-10-24	Moderna	Flu
4	2022-04-06	Moderna	No
5	2022-10-30	Pfizer-BioNTech	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-09

Systemic reaction (other): Blood sugar swings of 40 - 80 points. Type II diabetic.

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Blood sugar has been running higher than usual. Body not responding to insulin injections as usual.

2021-03-11

Systemic reaction (other): Blood Sugar still bouncing more than usual.

2021-03-12

Systemic reaction (other): Blood sugar less erratic than the last two days.

Release 6 — day 14, dose 1

2021-03-23

Symptoms: Moderate fatigue on late 8th and most of 9th day post vaccination.

Release 7 — day 0, dose 2

2021-04-09

Systemic reaction (other): Dehydration

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Blood Sugar running 30 points above normal.

2021-04-11

Systemic reaction (other): Lack of appetite.

2021-04-13

Systemic reaction (other): Blood sugar 25 points above normal readings.

2021-04-15

Systemic reaction (other): Short of breath but may be allergy related.

Release 10 — 6 months, dose 2

2021-10-08

Symptoms: Cataract surgery on right eye.

Release 12 — 6 months, dose 4

2022-10-05

Symptoms: Fall sinus and chest cold.

Healthcare visit (other): PCP

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	Office visit	·	·	✓
SD	Cataract operation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Sinus disorder	·	·	✓
SRO	Blood glucose abnormal	✓	✓	✓
SRO	Blood glucose fluctuation	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Diabetes mellitus	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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