5ZR-79101-23488

3 vaccinations 3 coded responses 41 check-ins 3 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 335 / FL
Registered: 2021-03-18

Relationship: Self
Race: White
Ethnicity: 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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site pruritus — Feeling: Good

Free text: A week after getting the vaccine I experienced redness, itchiness and soreness in the area where shot was given. 48 hours later symptoms were gone. I have not experienced any other symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-15
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
2021-12-10
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-24
Survey response — day 14, dose 3
MedDRA: Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities

Free text: Have had a rash since Tuesday that comes and goes away. When rash appears it itches. It's not a full body rash. Rash appears in line form or small patches. Rash moves to different parts of the body.

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — day 21, dose 3
MedDRA: Emergency care, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Last Sunday I went to hospital ER due to my rash. I was prescribed medication to alleviate the rash.

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-10
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-12-10	Moderna	No

Free text

Release 6 — day 14, dose 1

2021-04-01

Symptoms: A week after getting the vaccine I experienced redness, itchiness and soreness in the area where shot was given. 48 hours later symptoms were gone. I have not experienced any other symptoms.

Release 10 — day 14, dose 3

2021-12-24

Symptoms: Have had a rash since Tuesday that comes and goes away. When rash appears it itches. It's not a full body rash. Rash appears in line form or small patches. Rash moves to different parts of the body.

Release 10 — day 21, dose 3

2021-12-31

Symptoms: Last Sunday I went to hospital ER due to my rash. I was prescribed medication to alleviate the rash.

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	Emergency care	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓

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