5EG-19685-32556

4 vaccinations 11 coded responses 36 check-ins 10 free-text entries 3 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 200 / DC
Registered: 2021-03-11

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: All symptoms were mild and about 3-4 hours after innoculation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state — Feeling: Fair · Headache

Free text: Confusion several times during the day.

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

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough, Respiratory tract congestion — Feeling: Good · Joint pains

Free text: Mild chest congestion and phlegm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Productive cough, Respiratory tract congestion, Sputum increased — Feeling: Fair

Free text: Increased sputum, chest congestion, phlegm. Coughing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough, Respiratory tract congestion, Upper-airway cough syndrome — Feeling: Good

Free text: Post nasal drip, chest congestion, clear sputum.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Productive cough, Respiratory tract congestion — Feeling: Fair · Headache

Free text: Congestion, clear sputum, nagging cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 7, dose 2
MedDRA: Cough, Nasal congestion, Productive cough, Respiratory tract congestion — Feeling: Fair · Fever

Free text: Cough, chest congestion, clear sputum, nasal congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 14, dose 2
MedDRA: Respiratory tract congestion, Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chest congestion, sinus congestion, allergies I have never had.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Survey response — day 21, dose 2
MedDRA: Ear infection, Respiratory tract congestion, Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chest congestion, middle ear possible infection, sinus congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — day 28, dose 2
MedDRA: Ear congestion, Ear pain — Feeling: Fair

Free text: Congested middle ear, potential infection, earache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-13
Dose 3 — Moderna
2022-03-02
Call 1 — Left Voicemail
2022-10-05
Dose 4 — Moderna
2022-10-05
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Chills, Headache, Joint pains

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-04
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-05
Survey response — 6 months, dose 4
MedDRA: Nasopharyngitis, Office visit, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-05
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-06
Call successful
Does not wish to fill out VAERS report
2023-04-06
Call successful
Does not wish to fill out VAERS report
2023-04-06
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-12-13	Moderna	No
4	2022-10-05	Moderna	No

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): All symptoms were mild and about 3-4 hours after innoculation.

2021-03-13

Systemic reaction (other): Confusion several times during the day.

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Mild chest congestion and phlegm.

2021-04-12

Systemic reaction (other): Increased sputum, chest congestion, phlegm. Coughing.

2021-04-13

Systemic reaction (other): Post nasal drip, chest congestion, clear sputum.

2021-04-14

Systemic reaction (other): Congestion, clear sputum, nagging cough.

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Cough, chest congestion, clear sputum, nasal congestion.

Release 7 — day 14, dose 2

2021-04-22

Symptoms: Chest congestion, sinus congestion, allergies I have never had.

Release 8 — day 21, dose 2

2021-04-29

Symptoms: Chest congestion, middle ear possible infection, sinus congestion.

Release 8 — day 28, dose 2

2021-05-06

Symptoms: Congested middle ear, potential infection, earache.

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	Ear congestion	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sputum increased	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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