5PK-23009-37264

2 vaccinations 7 coded responses 24 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 505 / IA
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Ache that spider-webs out around my heart. 10-15 seconds each episodeabout 15 episodes thru the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Angina pectoris — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Spider-web of ache around heart a few times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Angina pectoris — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Heart ache spider webbing outward

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-24
Survey response — day 21, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tingling on left side of neckup into/around left ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Fatigue, Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increase in tingling left side of neck and ear. Fatigue and respiratory difficulty.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 35, dose 2
MedDRA: Paraesthesia, Paraesthesia ear — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increase in intensity and frequency of tingling sensation on left side of neck and ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Survey response — 6 months, dose 2
MedDRA: Brain fog — Feeling: Good · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-03-03
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Ache that spider-webs out around my heart. 10-15 seconds each episodeabout 15 episodes thru the day

2021-02-05

Systemic reaction (other): Spider-web of ache around heart a few times

2021-02-09

Systemic reaction (other): Heart ache spider webbing outward

Release 6 — day 21, dose 2

2021-03-24

Symptoms: Tingling on left side of neckup into/around left ear

Release 6 — day 28, dose 2

2021-03-31

Symptoms: Increase in tingling left side of neck and ear. Fatigue and respiratory difficulty.

Release 7 — day 35, dose 2

2021-04-07

Symptoms: Increase in intensity and frequency of tingling sensation on left side of neck and ear

Release 9 — 6 months, dose 2

2021-09-03

Symptoms: Brain fog

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	Brain fog	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Paraesthesia ear	○	✓	○
SRO	Angina pectoris	✓	✓	✓
SRO	Pain	✓	✓	✓

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