6E6-80647-87670

4 vaccinations 15 coded responses 52 check-ins 14 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 236 / VA
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test, SARS-CoV-2 test positive — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): I just learned that I had been exposed to someone in the days prior to the vaccination that subsequently tested positive for Covid. · Healthcare visit (other): Covid test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: SARS-CoV-2 test negative — Feeling: Good

Free text: My Covid test came back negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Dizzy upon waking up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-11
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: High heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness postural — Feeling: Good

Free text: Dizzy when getting out of bed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Good

Free text: Vertigo when going to bed last night and when getting out of bed this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Dizziness upon getting out of bed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 7, dose 2
MedDRA: Dizziness, Dizziness postural — Feeling: Good

Free text: Dizzy upon laying down and getting out of bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-31
Call 1 — Left Voicemail
2021-09-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Survey response — day 42, dose 3
MedDRA: Nasopharyngitis — Feeling: Good

Free text: Had cold symptoms since 11/29/21.

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Chest pain — Feeling: Fair

Free text: Chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Survey response — 12 months, dose 3
MedDRA: Hypothyroidism — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Hypothyroidism

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Dose 4 — Pfizer-BioNTech
2022-11-01
Health check-in — day 0, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-11-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-15
Survey response — day 14, dose 4
MedDRA: Diarrhoea, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Experienced vomiting and diarrhea on 11/09/22, but it may have from a listeria breakout as I ate cold deli meat.

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-13
Survey response — day 42, dose 4
MedDRA: Nephrolithiasis, Office visit — Feeling: Good · Be unable to work or attend school, 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: Symptoms: Kidney stones · Healthcare visit (other): Office visit, x-ray

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Report sent to call center — day 42, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-31
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-02
Survey response — 6 months, dose 4
MedDRA: Conjunctivitis, Herpes zoster — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-02
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna
3	2021-10-25	Pfizer-BioNTech	Flu
4	2022-11-01	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-15

Systemic reaction (other): I just learned that I had been exposed to someone in the days prior to the vaccination that subsequently tested positive for Covid.

Healthcare visit (other): Covid test

2021-02-17

Systemic reaction (other): My Covid test came back negative.

Release 4 — day 7, dose 1

2021-02-18

Systemic reaction (other): Dizzy upon waking up

Release 5 — days 1–6 daily, dose 2

2021-03-12

Systemic reaction (other): High heart rate

2021-03-14

Systemic reaction (other): Dizzy when getting out of bed

2021-03-15

Systemic reaction (other): Vertigo when going to bed last night and when getting out of bed this morning.

2021-03-16

Systemic reaction (other): Dizzy

2021-03-17

Systemic reaction (other): Dizziness upon getting out of bed

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): Dizzy upon laying down and getting out of bed.

Release 10 — day 42, dose 3

2021-12-06

Symptoms: Had cold symptoms since 11/29/21.

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: Chest pain

Release 12 — 12 months, dose 3

2022-10-25

Symptoms: Hypothyroidism

Release 12 — day 14, dose 4

2022-11-15

Symptoms: Experienced vomiting and diarrhea on 11/09/22, but it may have from a listeria breakout as I ate cold deli meat.

Release 12 — day 42, dose 4

2022-12-13

Symptoms: Kidney stones

Healthcare visit (other): Office visit, x-ray

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	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Conjunctivitis	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Hypothyroidism	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Vomiting	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dizziness postural	✓	✓	✓
SRO	Exposure to SARS-CoV-2	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓
SRO	SARS-CoV-2 test positive	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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