6EH-19974-40556

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 782 / TX
Registered: 2021-03-31

Relationship: Self
Race: White
Ethnicity: Not 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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Moderna
2021-03-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Tenderness — Feeling: Fair · Site: Pain · Headache, Joint pains

Free text: Mild earache and mild tenderness in glands below ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Lymph node pain, Pain in jaw — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Free text: Mild ear ache for lack a better description. Jaw joint was sore and tenderness in lymph glands in neck.

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

Free text: Fever and chills were early last night after yesterday's report and gone this morning. Headache has been off and on since my vacation but is greatly diminished. Body aches were yesterday and last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

Free text: On 4/07/21 & 4/08/21 the injection site became very sore. There had been no real noticeable soreness for the past few days. It had gradually diminished but when I woke up on the 7th it was very sore. No physical activity that would account for it.

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

Adult check-in
2021-04-28
Dose 2 — Moderna
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Injection site pain, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: More pain at injection site than first shot. Headache is worse. Fever started about 21 hours after the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash, Rash, Self-medication — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: I had to take Benadryl to control the rash.. It started at the injection site and down my arm the other day. About midmorning today I suddenly broke out on my back, face and neck.c

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Headache, Fatigue or tiredness

Free text: Headaches are intermittent, come and go

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Survey response — 12 months, dose 2
MedDRA: COVID-19, Dyspnoea — Feeling: Good · Be unable to work or attend school

Free text: Some periodical mild shortness of breath started after I contracted COVID19.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna
2	2021-04-28	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): Mild earache and mild tenderness in glands below ears

2021-04-02

Systemic reaction (other): Mild ear ache for lack a better description. Jaw joint was sore and tenderness in lymph glands in neck.

2021-04-03

Systemic reaction (other): Fever and chills were early last night after yesterday's report and gone this morning. Headache has been off and on since my vacation but is greatly diminished. Body aches were yesterday and last night.

Release 7 — day 14, dose 1

2021-04-14

Symptoms: On 4/07/21 & 4/08/21 the injection site became very sore. There had been no real noticeable soreness for the past few days. It had gradually diminished but when I woke up on the 7th it was very sore. No physical activity that would account for it.

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): More pain at injection site than first shot. Headache is worse. Fever started about 21 hours after the injection

2021-05-02

Systemic reaction (other): I had to take Benadryl to control the rash.. It started at the injection site and down my arm the other day. About midmorning today I suddenly broke out on my back, face and neck.c

2021-05-04

Systemic reaction (other): Headaches are intermittent, come and go

Release 11 — 12 months, dose 2

2022-04-29

Symptoms: Some periodical mild shortness of breath started after I contracted COVID19.

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	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Injection site pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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