6AM-28250-04928

3 vaccinations 9 coded responses 18 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 36-40
ZIP prefix: 321 / FL
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Survey response — day 0, dose 1
MedDRA: Flushing, Sensory disturbance — Feeling: Fair · Site: Pain, Swelling

Free text: Feeling flush. Not your typical fever feeling but a feeling of blood circulating after an good workout exercise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Disturbance in attention — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Inattentive focus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Not sure if residual fatigue is due to vaccine or not. I am tired a lot more.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — day 0, dose 2
MedDRA: Pain, Reaction to previous exposure to any vaccine — Feeling: Good · Fatigue or tiredness

Free text: Extremely mild soreness. Same as if I got a flu shot. No additional symptoms yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis, Condition aggravated, Gout, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: My joints were not feeling great yesterday and today. Felt like arthritis and or gout, but Im on medication for those so its likely not that. I believe this was a reaction.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-30
Dose 3 — Moderna
Co-administered: yes
2021-09-30
Survey response — day 0, dose 3
MedDRA: Arthralgia — Feeling: Poor · Site: Pain, Redness, Swelling · 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 dont have a fever, but the way my joints are feeling pain: might be around the corner.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-10-21
Survey response — day 21, dose 3
MedDRA: Back pain, High frequency ablation — Feeling: Fair · Be unable to do your normal daily activities

Free text: My lower back is starting to feel pain, and I medically can't. I had a radio frequency ablation lower lumbar. Wondering if immune system boost triggered a regrowth of nerves.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-30
Survey response — 3 months, dose 3
MedDRA: Cardiac flutter — Feeling: Fair

Free text: Feeling heart flutters.

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Survey response — 6 months, dose 3
MedDRA: Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Extreme fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-09-30	Moderna	Yes

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-03

Systemic reaction (other): Feeling flush. Not your typical fever feeling but a feeling of blood circulating after an good workout exercise

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Inattentive focus

2021-03-08

Systemic reaction (other): Not sure if residual fatigue is due to vaccine or not. I am tired a lot more.

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): Extremely mild soreness. Same as if I got a flu shot. No additional symptoms yet.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): My joints were not feeling great yesterday and today. Felt like arthritis and or gout, but Im on medication for those so its likely not that. I believe this was a reaction.

Release 9 — day 0, dose 3

2021-09-30

Systemic reaction (other): I dont have a fever, but the way my joints are feeling pain: might be around the corner.

Release 10 — day 21, dose 3

2021-10-21

Symptoms: My lower back is starting to feel pain, and I medically can't. I had a radio frequency ablation lower lumbar. Wondering if immune system boost triggered a regrowth of nerves.

Release 10 — 3 months, dose 3

2021-12-30

Symptoms: Feeling heart flutters.

Release 11 — 6 months, dose 3

2022-04-04

Symptoms: Extreme fatigue.

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	Back pain	·	·	✓
SD	Cardiac flutter	·	·	✓
SD	Fatigue	·	·	✓
SD	High frequency ablation	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Arthritis	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Gout	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Sensory disturbance	✓	✓	✓

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