5MD-37107-77729

4 vaccinations 13 coded responses 46 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 928 / CA
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — day 14, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stiff neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Physical tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Dose 2 — Moderna
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-07
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-29
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-30
Dose 3 — Moderna
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site discolouration — Feeling: Fair · Site: Pain, Redness, Swelling

Free text: Excessive non-bruising superficial discoloration at injection site.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Skin discolouration — Feeling: Fair · Site: Pain, Redness

Free text: Superficial discoloration in top layers of skin, never previously associated with any other vaccinations or intramuscular injections.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-22
Survey response — day 21, dose 3
MedDRA: Paranasal sinus hyposecretion, Sinonasal obstruction — Feeling: Fair

Free text: Dry and blocked sinuses

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-29
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Dose 4 — Moderna
2022-05-15
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-17
Survey response — days 1–6 daily, dose 4
MedDRA: Chest pain, Dyspnoea — Feeling: Fair · Site: Pain

Free text: Chest pain, heavy breathing

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-05-25
Survey response — day 14, dose 4
MedDRA: Headache, Injection site pain — Feeling: Fair

Free text: Injection site pain & headache

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-08
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-15
Survey response — day 35, dose 4
MedDRA: Burning sensation, Cough, Fatigue, Oropharyngeal pain, Productive cough, Respiratory tract congestion, Rhinorrhoea — 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

Free text: Burning sinus, congestion, runny nose, fatigue, non-productive cough, productive cough, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Report sent to call center — day 35, 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 · 1 call case(s)
2022-06-16
Call 1 — Left Voicemail
2022-06-22
Survey response — day 42, dose 4
MedDRA: Arthralgia, Cough, Lethargy, Nasal discomfort, Neck pain — Feeling: Fair · 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

Free text: Burning sinus, cough, lethargy, neck & shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — day 42, 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 · 1 call case(s)
2022-06-23
Call 2 — Left Voicemail
2022-06-23
Call 1 — Left Voicemail
2022-08-10
Survey response — 3 months, dose 4
MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ongoing shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — 6 months, dose 4
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-10-30	Moderna	No
4	2022-05-11	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-15

Symptoms: Stiff neck

Release 7 — day 21, dose 1

2021-04-22

Symptoms: Physical tiredness

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Excessive non-bruising superficial discoloration at injection site.

2021-11-01

Systemic reaction (other): Superficial discoloration in top layers of skin, never previously associated with any other vaccinations or intramuscular injections.

Release 10 — day 21, dose 3

2021-11-22

Symptoms: Dry and blocked sinuses

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: Sore throat

Release 11 — days 1–6 daily, dose 4

2022-05-15

Systemic reaction (other): Sore throat

2022-05-17

Systemic reaction (other): Chest pain, heavy breathing

Release 11 — day 14, dose 4

2022-05-25

Symptoms: Injection site pain & headache

Release 12 — day 35, dose 4

2022-06-15

Symptoms: Burning sinus, congestion, runny nose, fatigue, non-productive cough, productive cough, sore throat

Release 12 — day 42, dose 4

2022-06-22

Symptoms: Burning sinus, cough, lethargy, neck & shoulder pain

Release 12 — 3 months, dose 4

2022-08-10

Symptoms: Ongoing shortness of breath

Release 12 — 6 months, dose 4

2022-11-11

Symptoms: Diarrhea

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	Arthralgia	·	·	✓
SD	Burning sensation	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site pain	·	·	✓
SD	Lethargy	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nasal discomfort	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus hyposecretion	·	·	✓
SD	Productive cough	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinonasal obstruction	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Injection site discolouration	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Skin discolouration	·	·	✓

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