5JM-63075-19644

3 vaccinations 5 coded responses 32 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 16-20
ZIP prefix: 785 / TX
Registered: 2021-02-09

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-06
Dose 1 — Moderna
2021-02-09
Registered in v-safe
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Headache, Myalgia, Pain, Pyrexia — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: Sunday Feb 7 I had fever, chills, headache, muscle and body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-02-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-28
Survey response — day 21, dose 1
MedDRA: Deafness, Ear infection, Otorrhoea, Respiratory tract congestion — Feeling: Good

Free text: Ear infection...loss of hearing for a few days then fluid discharge on right ear. Lots of congestion. Thought were allergies but congestion was part of infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Dose 2 — Moderna
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Fatigue or tiredness

Free text: Itching but not at the injection site and no rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Office visit, Respiratory tract congestion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have congestion that has been ongoing. · Healthcare visit (other): in office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
Co-administered: Flu
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Injection site pain — Feeling: Good

Free text: Following day after injection I felt pain at the injection site and I felt tired but today I feel better.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-07
Call 1 — Left Voicemail
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-29
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-05	Moderna
3	2021-10-29	Moderna	Flu

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Sunday Feb 7 I had fever, chills, headache, muscle and body aches

Release 4 — day 21, dose 1

2021-02-28

Symptoms: Ear infection...loss of hearing for a few days then fluid discharge on right ear. Lots of congestion. Thought were allergies but congestion was part of infection.

Release 5 — days 1–6 daily, dose 2

2021-03-08

Systemic reaction (other): Itching but not at the injection site and no rash

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: I have congestion that has been ongoing.

Healthcare visit (other): in office visit

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): Following day after injection I felt pain at the injection site and I felt tired but today I feel better.

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	Deafness	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Otorrhoea	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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