5VV-89208-13375

5 vaccinations 5 coded responses 28 check-ins 4 free-text entries 4 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 199 / DE
Registered: 2021-01-11

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

2021-01-11
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-18
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 · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Survey response — day 14, dose 2
MedDRA: Arthralgia, Erythema, Muscle tightness, Rash, Telemedicine — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Rash covering both arms & front of torso. Not on my face or back and minimal below the waist. The rash is not painful nor itchy. Marks are light red & flat. Varying knee & elbow pain (muscles tight) that fluctuates from tolerable to difficult. · Healthcare visit (other): Scheduled telehealth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Survey response — day 21, dose 2
MedDRA: Arthralgia, Fatigue, Rash, Rash erythematous — Feeling: Fair · 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: Ive had a rash over most of my body for nearly three weeks. My doctor has me taking zyrtec, but its not making a difference so far. Rash has 1cm size red dots. Flat, not itchy nor painful. Also, fatigue and joint pain persist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Survey response — day 28, dose 2
MedDRA: Arthralgia, Myalgia, Pain in extremity, Rash — Feeling: Fair · 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: My all-over rash persists, fading, but still visible. My doc rx Zyrtec daily which seems to help. Muscle pain is a dull ache in both knees, & a sharp, referring pain in my left wrist, extending to that pinky - pain is off and on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Survey response — day 42, dose 2
MedDRA: Fatigue, Rash, Unevaluable event — Feeling: Fair · 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: Symptoms: Rash has faded from most of my body, but is still quite prevalent in my lower legs & feet. The spots are merging into larger patches. Dermatologist yesterday rx triaminiclone .1%. Fatigue persists, but its hard to know if its a side effect · Healthcare visit (other): Dermatologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
Co-administered: Flu
2021-12-20
Call 1 — Left Voicemail
2022-04-25
Dose 4 — Moderna
2022-05-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Dose 5 — Moderna
Co-administered: Flu
2022-10-24
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-31
Survey response — 6 months, dose 5
MedDRA: Cough, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna
3	2021-11-04	Moderna	Flu
4	2022-04-25	Moderna	No
5	2022-09-30	Moderna	Flu

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 14, dose 2

2021-02-26

Symptoms: Rash covering both arms & front of torso. Not on my face or back and minimal below the waist. The rash is not painful nor itchy. Marks are light red & flat. Varying knee & elbow pain (muscles tight) that fluctuates from tolerable to difficult.

Healthcare visit (other): Scheduled telehealth

Release 5 — day 21, dose 2

2021-03-05

Symptoms: Ive had a rash over most of my body for nearly three weeks. My doctor has me taking zyrtec, but its not making a difference so far. Rash has 1cm size red dots. Flat, not itchy nor painful. Also, fatigue and joint pain persist

Release 5 — day 28, dose 2

2021-03-13

Symptoms: My all-over rash persists, fading, but still visible. My doc rx Zyrtec daily which seems to help. Muscle pain is a dull ache in both knees, & a sharp, referring pain in my left wrist, extending to that pinky - pain is off and on

Release 6 — day 42, dose 2

2021-03-26

Symptoms: Rash has faded from most of my body, but is still quite prevalent in my lower legs & feet. The spots are merging into larger patches. Dermatologist yesterday rx triaminiclone .1%. Fatigue persists, but its hard to know if its a side effect

Healthcare visit (other): Dermatologist

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	Telemedicine	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Muscle tightness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓

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