5PH-96408-57376

3 vaccinations 7 coded responses 37 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 200 / DC
Registered: 2021-03-27

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

2021-03-27
Registered in v-safe
2021-03-27
Dose 1 — Moderna
2021-03-27
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site reaction — Feeling: Good · Site: Pain

Free text: Mild involuntary muscle spasms near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — day 28, dose 2
MedDRA: Chronic sinusitis, Cough, Lung disorder, Nasal irrigation, Pyrexia, Self-medication, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Chronic sinusitis with fever, day 5. No loss of smell or any lung issues yet (self-examination normal). Treating with Claritin-D, Advil and saline nasal irrigation. If I am not better in the next few days I will see a doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Survey response — 3 months, dose 2
MedDRA: Influenza like illness — Feeling: Good

Free text: Mild flu like symptoms for three days. No fever.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-25
Survey response — 6 months, dose 2
MedDRA: Influenza like illness, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: I had flu like symptoms with mild fever for two days but I was not tested for Covid.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Dose 3 — Moderna
2021-11-22
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Inflammation, Joint injury, Pain, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I am recovering from an ankle injury, the fever and inflammation in reaction to the vaccine made the pain unbearable the last 12 hours, but it is improving.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Possible right ankle reactive arthritis

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-11-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-21
Survey response — 3 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities

Free text: Omicron infection

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-11-22	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-29

Systemic reaction (other): Mild involuntary muscle spasms near injection site

Release 8 — day 28, dose 2

2021-05-22

Symptoms: Chronic sinusitis with fever, day 5. No loss of smell or any lung issues yet (self-examination normal). Treating with Claritin-D, Advil and saline nasal irrigation. If I am not better in the next few days I will see a doctor.

Release 9 — 3 months, dose 2

2021-07-24

Symptoms: Mild flu like symptoms for three days. No fever.

Release 10 — 6 months, dose 2

2021-10-25

Symptoms: I had flu like symptoms with mild fever for two days but I was not tested for Covid.

Release 10 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): I am recovering from an ankle injury, the fever and inflammation in reaction to the vaccine made the pain unbearable the last 12 hours, but it is improving.

2021-11-24

Systemic reaction (other): Possible right ankle reactive arthritis

Release 11 — 3 months, dose 3

2022-02-21

Symptoms: Omicron infection

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	Chronic sinusitis	·	·	✓
SD	Cough	✓	✓	○
SD	COVID-19	·	·	✓
SD	Influenza like illness	✓	·	✓
SD	Lung disorder	✓	✓	○
SD	Nasal irrigation	✓	✓	○
SD	Pyrexia	✓	✓	✓
SD	Self-medication	·	·	✓
SD	Sinusitis	✓	✓	○
SRO	Inflammation	·	·	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Joint injury	·	·	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Unevaluable event	·	·	✓

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