5MC-12555-54347

4 vaccinations 7 coded responses 22 check-ins 7 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 802 / CO
Registered: 2021-04-09

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

2021-03-08
Dose 1 — Moderna
2021-04-09
Registered in v-safe
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Disturbance in attention, Hypersomnia, Pre-existing disease — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My stimulant ADHD medication no longer works for focus and attention. I sleep up to 24-36 hours at a time since the 2nd vaccine, this never happened before. Also, I had a leftover Vyvanse Rx from 11 months ago, it no longer helps with wakefulness, arousal, focus, attention, the vaccine made me non-functional again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Health check-in — day 28, dose 2
Feeling: Fair

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

Adult check-in
2021-05-22
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
2021-10-29
Dose 3 — Moderna
Co-administered: Flu
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Cellulitis, Confusional state, Sepsis — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: confusion, same symptoms as cellulitis or sepsis, I am going to go to the ER and get checked out.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2021-11-04
Call 1 — Left Voicemail
2021-11-05
Survey response — day 7, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: took COVID test Thursday result was negative at (b)(6), they said I probably have a cold . They did urine, blood, tests nothing to indicate I was sicker than just having a seasonal cold. At 53 it wipes me out LOTS more than it did at 20 & 30.

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-11-08
Call 1 — Could Not Reach Participant
2021-11-11
Call 2 — Could Not Reach Participant
2021-11-12
Survey response — day 14, dose 3
MedDRA: Blood potassium decreased, Decreased appetite, Dysphagia, Electrocardiogram QT prolonged, Electrocardiogram abnormal, Headache, Rhinovirus infection — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: rhinovirus, headaches, low potassium, poor appetite, difficulty swallowing taking supplements I have been on for years, QT Prolongation EKG 482 very out of range.

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-11-16
Call 1 — Could Not Reach Participant
2021-11-19
Survey response — day 21, dose 3
MedDRA: Nasopharyngitis — Feeling: Poor · 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

Free text: Cold will not heal. I have never been a minute late paying rent in my life, but 3rd eviction keeps me too busy to get medical care.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 21, dose 3
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)
2021-11-23
Call 2 — Could Not Reach Participant
2021-11-27
Survey response — day 28, dose 3
MedDRA: Cough, Emergency care, Nasopharyngitis, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I still have cold symptoms with cough congestion which got worse, so I went to the hospital for an emergency checkup.

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-12-01
Call 1 — Left Voicemail
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
2022-07-03
Dose 4 — Moderna
2022-11-01
Survey response — 12 months, dose 3
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Runny nose, chest congestion

MedDRA releases: 2024-11 · check-in free text available
2023-01-02
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-09	Moderna
3	2021-10-29	Moderna	Flu
4	2022-07-03	Moderna	No

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): My stimulant ADHD medication no longer works for focus and attention. I sleep up to 24-36 hours at a time since the 2nd vaccine, this never happened before. Also, I had a leftover Vyvanse Rx from 11 months ago, it no longer helps with wakefulness, arousal, focus, attention, the vaccine made me non-functional again.

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): confusion, same symptoms as cellulitis or sepsis, I am going to go to the ER and get checked out.

Release 10 — day 7, dose 3

2021-11-05

Healthcare visit (other): took COVID test Thursday result was negative at (b)(6), they said I probably have a cold . They did urine, blood, tests nothing to indicate I was sicker than just having a seasonal cold. At 53 it wipes me out LOTS more than it did at 20 & 30.

redacted (b)(6)

Release 10 — day 14, dose 3

2021-11-12

Symptoms: rhinovirus, headaches, low potassium, poor appetite, difficulty swallowing taking supplements I have been on for years, QT Prolongation EKG 482 very out of range.

Release 10 — day 21, dose 3

2021-11-19

Symptoms: Cold will not heal. I have never been a minute late paying rent in my life, but 3rd eviction keeps me too busy to get medical care.

Release 10 — day 28, dose 3

2021-11-27

Symptoms: I still have cold symptoms with cough congestion which got worse, so I went to the hospital for an emergency checkup.

Release 12 — 12 months, dose 3

2022-11-01

Symptoms: Runny nose, chest congestion

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	Nasopharyngitis	·	·	✓
HCVO	SARS-CoV-2 test negative	·	·	✓
SD	Blood potassium decreased	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Dysphagia	·	·	✓
SD	Electrocardiogram abnormal	·	·	✓
SD	Electrocardiogram QT prolonged	·	·	✓
SD	Emergency care	·	·	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Rhinovirus infection	·	·	✓
SRO	Cellulitis	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Confusional state	·	·	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sepsis	·	·	✓

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