6GM-23105-40565

3 vaccinations 9 coded responses 34 check-ins 9 free-text entries 0 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 954 / CA
Registered: 2021-04-18

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

2021-04-12
Dose 1 — Moderna
2021-04-18
Registered in v-safe
2021-04-19
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-10
Dose 2 — Moderna
2021-05-10
Survey response — day 0, dose 2
MedDRA: Ear discomfort, Feeling abnormal, Immediate post-injection reaction — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Plugged ears. Maybe seasonal allergies, but were not plugged before injection and felt plugged around 30 minutes after. Also very spacey feeling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Ear disorder, Feeling abnormal, Paraesthesia — Feeling: Poor · Site: Pain, Swelling · 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: Spacey. Plugged ears. Tingling skin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Muscle tightness, Paraesthesia, Poor quality sleep — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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: Plugged ears. Tingling skin. Tight muscles. Poor sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Ear discomfort — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Plugged ears. Light headed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-31
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-07
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-14
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Excessive fatigue onset.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-10
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-15
Dose 3 — Moderna
2021-11-15
Health check-in — day 0, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: 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

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-22
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-29
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-13
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-20
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-27
Survey response — day 42, dose 3
MedDRA: Decreased interest, Diarrhoea, Dizziness, Pain — Feeling: Fair

Free text: Body aches, diarrhea, light-headed distant feeling

MedDRA releases: 2024-11 · check-in free text available
2022-02-14
Survey response — 3 months, dose 3
MedDRA: Fatigue, Headache, Nausea, Pain — Feeling: Fair · Be unable to work or attend school

Free text: Headache, fatigue, nausea, body aches

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Survey response — 6 months, dose 3
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Fair

Free text: Allergies. Much worse this year.

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Survey response — 12 months, dose 3
MedDRA: Brain fog, Malaise, Pain — Feeling: Fair · Be unable to work or attend school

Free text: Very sick from Pfizer booster. Body aches. Foggy headed.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-12	Moderna
2	2021-05-10	Moderna
3	2021-11-15	Moderna	No

Free text

Release 8 — day 0, dose 2

2021-05-10

Systemic reaction (other): Plugged ears. Maybe seasonal allergies, but were not plugged before injection and felt plugged around 30 minutes after. Also very spacey feeling.

Release 8 — days 1–6 daily, dose 2

2021-05-11

Systemic reaction (other): Spacey. Plugged ears. Tingling skin.

2021-05-12

Systemic reaction (other): Plugged ears. Tingling skin. Tight muscles. Poor sleep.

2021-05-13

Systemic reaction (other): Plugged ears. Light headed.

Release 9 — day 35, dose 2

2021-06-14

Symptoms: Excessive fatigue onset.

Release 10 — day 42, dose 3

2021-12-27

Symptoms: Body aches, diarrhea, light-headed distant feeling

Release 11 — 3 months, dose 3

2022-02-14

Symptoms: Headache, fatigue, nausea, body aches

Release 11 — 6 months, dose 3

2022-05-16

Symptoms: Allergies. Much worse this year.

Release 12 — 12 months, dose 3

2022-11-16

Symptoms: Very sick from Pfizer booster. Body aches. Foggy headed.

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	Brain fog	·	·	✓
SD	Decreased interest	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear disorder	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Muscle tightness	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓

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