5PT-26655-57220

5 vaccinations 10 coded responses 34 check-ins 10 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 939 / CA
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Muscle or body aches

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Good

Free text: Occasional ringing in ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · Headache, Vomiting

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-27
Survey response — day 21, dose 1
MedDRA: Tinnitus — Feeling: Good

Free text: Some more ringing in ears, generally mild. I notice it more at nighttime.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: Tinnitus — Feeling: Good · Joint pains

Free text: Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral coldness — Feeling: Fair · Site: Redness · Fever · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Cold toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Vomiting

Adult check-in
2021-04-09
Survey response — day 7, dose 2
MedDRA: Muscular weakness — Feeling: Good · Joint pains

Free text: Mild weakness in legs. Also, some unusual sensations in skin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 28, dose 2
MedDRA: Eye pruritus, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Good

Free text: I think I caught a cold this week. (Sneezing, runny nose, congestion, itchy eyes). It was strange because my last one must have been before the Pandemic, so like well over a year ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Cough — Feeling: Good

Free text: Some mild coughing, occasionally, usually right when I get out of bed but not persistent otherwise. Also some occasional sharp short pains in wrists/forearms, shins and lower chest. Wouldnt mention it except its similar to mid-2020.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Middle ear effusion, Vertigo — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Excess fluid in ear ; vertigo. Lasted about 10 days. Possibly related to allergies/air quality.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-06
Call 1 — Left Voicemail
2021-10-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-19
Dose 3 — Pfizer-BioNTech
2022-04-05
Survey response — 12 months, dose 2
MedDRA: Hypoaesthesia — Feeling: Good

Free text: A slight numbness on the surface of my right hip area. This is since about a month ago, the beginning of March.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Dose 4 — Pfizer-BioNTech
2022-05-04
Survey response — day 7, dose 4
MedDRA: Headache, Myalgia, Pain — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: I experienced headache three days ago. Muscle and body aches since two days ago, now trailing off.

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-22
Dose 5 — Moderna
2023-04-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in
2023-06-25
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-11-19	Pfizer-BioNTech	No
4	2022-04-26	Pfizer-BioNTech	No
5	2022-12-22	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Occasional ringing in ear

Release 6 — day 21, dose 1

2021-03-27

Symptoms: Some more ringing in ears, generally mild. I notice it more at nighttime.

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): Tinnitus

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Cold toes

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): Mild weakness in legs. Also, some unusual sensations in skin.

Release 8 — day 28, dose 2

2021-04-30

Symptoms: I think I caught a cold this week. (Sneezing, runny nose, congestion, itchy eyes). It was strange because my last one must have been before the Pandemic, so like well over a year ago.

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Some mild coughing, occasionally, usually right when I get out of bed but not persistent otherwise. Also some occasional sharp short pains in wrists/forearms, shins and lower chest. Wouldnt mention it except its similar to mid-2020.

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: Excess fluid in ear ; vertigo. Lasted about 10 days. Possibly related to allergies/air quality.

Release 11 — 12 months, dose 2

2022-04-05

Symptoms: A slight numbness on the surface of my right hip area. This is since about a month ago, the beginning of March.

Release 11 — day 7, dose 4

2022-05-04

Systemic reaction (other): I experienced headache three days ago. Muscle and body aches since two days ago, now trailing off.

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	Cough	✓	✓	✓
SD	Eye pruritus	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Middle ear effusion	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Vertigo	·	·	✓
SRO	Headache	·	·	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Pain	·	·	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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