5E4-15840-66332

2 vaccinations 11 coded responses 26 check-ins 11 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 961 / CA
Registered: 2021-08-14

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-08-14
Registered in v-safe
2021-08-14
Dose 1 — Moderna
2021-08-14
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-15
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Cough, Faeces soft, Fatigue, Headache, Mobility decreased, Nausea, Pain, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I had covid previously. I have symptoms severe enough that I stayed in bed all day. Tired achy joint pain. Coughing headaches. Nausea, almost diarrhea. So smoky here so not sure what is related to vaccine. Feel like I have covid again but less.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-16
Survey response — days 1–6 daily, dose 1
MedDRA: Balance disorder — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Still some lack of balance

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-18
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good · Site: Redness, Itching · Headache

Free text: Coughing

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-08-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-09-04
Survey response — day 21, dose 1
MedDRA: Cough, Diarrhoea — Feeling: Good

Free text: Diarrhea and coughing

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-11
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-09-14
Dose 2 — Moderna
2021-09-15
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Skin warm — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Body like a furnace, leg cramps

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-09-17
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-09-19
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Good · Site: Redness · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available
2021-09-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-09-21
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Fever · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-09-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-10-05
Survey response — day 21, dose 2
MedDRA: Cough, Fatigue, Pre-existing disease, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: Coughing worse. Continuing low grade fever and fatigue. Probably shouldn't have gotten vaccine as i already had covid. I don't need these Continuing problems that affect daily life. Have scheduled physician appointment.

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-10-22
Survey response — day 35, dose 2
MedDRA: Cough, Fatigue, Pyrexia — Feeling: Good

Free text: Constant low grade fever, coughing, fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — day 42, dose 2
MedDRA: Abdominal pain upper, Body temperature decreased, Diarrhoea, General physical health deterioration, Pyrexia — Feeling: Good

Free text: Have had stomach pains and diarrhea since vax but did not attribute to vax. Low grade fever is mostly gone. Currently has been 96.9 to 97.7 so better. Health about the same as before last vax but worse than before 1st vax.

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — 3 months, dose 2
MedDRA: Headache, Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stiff neck and major headache. Don't have a clue if related to vaccination. Am assuming not due to time lapse.

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-09-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-14	Moderna	No
2	2021-09-14	Moderna	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-15

Systemic reaction (other): I had covid previously. I have symptoms severe enough that I stayed in bed all day. Tired achy joint pain. Coughing headaches. Nausea, almost diarrhea. So smoky here so not sure what is related to vaccine. Feel like I have covid again but less.

2021-08-16

Systemic reaction (other): Still some lack of balance

2021-08-18

Systemic reaction (other): Coughing

Release 9 — day 21, dose 1

2021-09-04

Symptoms: Diarrhea and coughing

Release 9 — days 1–6 daily, dose 2

2021-09-15

Systemic reaction (other): Body like a furnace, leg cramps

2021-09-17

Systemic reaction (other): Coughing

2021-09-19

Systemic reaction (other): Coughing

Release 10 — day 21, dose 2

2021-10-05

Symptoms: Coughing worse. Continuing low grade fever and fatigue. Probably shouldn't have gotten vaccine as i already had covid. I don't need these Continuing problems that affect daily life. Have scheduled physician appointment.

Release 10 — day 35, dose 2

2021-10-22

Symptoms: Constant low grade fever, coughing, fatigue.

Release 10 — day 42, dose 2

2021-10-26

Symptoms: Have had stomach pains and diarrhea since vax but did not attribute to vax. Low grade fever is mostly gone. Currently has been 96.9 to 97.7 so better. Health about the same as before last vax but worse than before 1st vax.

Release 10 — 3 months, dose 2

2021-12-14

Symptoms: Stiff neck and major headache. Don't have a clue if related to vaccination. Am assuming not due to time lapse.

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	Abdominal pain upper	·	·	✓
SD	Body temperature decreased	·	·	✓
SD	Cough	✓	·	✓
SD	Diarrhoea	✓	·	✓
SD	Fatigue	·	·	✓
SD	General physical health deterioration	·	·	✓
SD	Headache	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Arthralgia	✓	·	✓
SRO	Balance disorder	✓	·	✓
SRO	Cough	✓	·	✓
SRO	Faeces soft	✓	·	✓
SRO	Fatigue	✓	·	✓
SRO	Headache	✓	·	✓
SRO	Mobility decreased	✓	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Nausea	✓	·	✓
SRO	Pain	✓	·	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Skin warm	·	·	✓

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