6AR-33741-45956

2 vaccinations 19 coded responses 27 check-ins 19 free-text entries 3 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 498 / MI
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Syncope — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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

Free text: EXTREME shortness of breath and I fainted at work cant go to er since they cant help and are booked with seven hour wait times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Dyspnoea — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Lots of confusion but the shortness of breath is slightly better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Headache — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Fairly significant headache with confusion

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

Free text: Still have shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Dyspnoea — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breath and confusion

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

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-18
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Severe fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 28, dose 1
MedDRA: Confusional state, Dyspnoea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Constant shortness of breath and confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Dose 2 — Moderna
2021-02-26
Survey response — day 0, dose 2
MedDRA: Dyspnoea, Vomiting — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: SEVERE shortness of breath and vomiting this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: EXTREME fatigue and EXTREME shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme fatigue and shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: SEVERE shortness of breath and fatigue

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

Free text: SEVERE shortness of breath and SEVERE fatigue and aches

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

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-12
Survey response — day 14, dose 2
MedDRA: Confusional state, Dyspnoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: SEVERE shortness of breath and confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 21, dose 2
MedDRA: Ageusia, Anosmia, Dyspnoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: I have SEVERE shortness of breath and a loss of taste and smell that isnt going away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 28, dose 2
MedDRA: Ageusia, Anosmia, Dyspnoea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I have absolutely no sense of smell and minimal taste and SEVERE SEVERE shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Dyspnoea, Narcolepsy, Pre-existing disease — Feeling: Poor · Be unable to work, 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: Significantly worse shortness of breath and borderline narcolepsy

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

1 call case(s)
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Apnoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Apnea (caused by the vaccine)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 1 — Left Voicemail
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Anosmia, Dyspnoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Complete loss of smell and constant shortness of breath

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-26
Survey response — 12 months, dose 2
MedDRA: Ageusia, Anosmia, Dyspnoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Total loss of taste and smell permanently and constant severe shortness of breath

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-26	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): EXTREME shortness of breath and I fainted at work cant go to er since they cant help and are booked with seven hour wait times

2021-01-31

Systemic reaction (other): Lots of confusion but the shortness of breath is slightly better

2021-02-01

Systemic reaction (other): Fairly significant headache with confusion

2021-02-02

Systemic reaction (other): Still have shortness of breath

2021-02-03

Systemic reaction (other): Shortness of breath and confusion

Release 4 — day 21, dose 1

2021-02-18

Symptoms: Severe fatigue

Release 4 — day 28, dose 1

2021-02-25

Symptoms: Constant shortness of breath and confusion

Release 4 — day 0, dose 2

2021-02-26

Systemic reaction (other): SEVERE shortness of breath and vomiting this morning

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): EXTREME fatigue and EXTREME shortness of breath

2021-02-28

Systemic reaction (other): Extreme fatigue and shortness of breath

2021-03-02

Systemic reaction (other): SEVERE shortness of breath and fatigue

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): SEVERE shortness of breath and SEVERE fatigue and aches

Release 5 — day 14, dose 2

2021-03-12

Symptoms: SEVERE shortness of breath and confusion

Release 5 — day 21, dose 2

2021-03-19

Symptoms: I have SEVERE shortness of breath and a loss of taste and smell that isnt going away

Release 6 — day 28, dose 2

2021-03-26

Symptoms: I have absolutely no sense of smell and minimal taste and SEVERE SEVERE shortness of breath

Release 7 — day 42, dose 2

2021-04-09

Symptoms: Significantly worse shortness of breath and borderline narcolepsy

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Apnea (caused by the vaccine)

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Complete loss of smell and constant shortness of breath

Release 11 — 12 months, dose 2

2022-02-26

Symptoms: Total loss of taste and smell permanently and constant severe shortness of breath

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	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Apnoea	✓	✓	✓
SD	Condition aggravated	○	✓	○
SD	Confusional state	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Narcolepsy	✓	✓	✓
SD	Pre-existing disease	○	✓	○
SRO	Confusional state	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Syncope	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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