6GX-12341-16029

5 vaccinations 4 coded responses 33 check-ins 4 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 209 / MD
Registered: 2021-01-30

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
Dose 1 — Moderna
2021-01-30
Registered in v-safe
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Office visit, Prostatitis — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Prostatitis. · Healthcare visit (other): Visited doctor in office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Dose 3 — Moderna
2021-10-27
Survey response — day 21, dose 3
MedDRA: Malaise, Office visit, Pain in extremity, Prostatitis, Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Prostatitis (during the summer, treated with anti-biotics and Tamsulosin). Sore arm for three days and general malaise for several says following 3rd covid shot. · Healthcare visit (other): Visited urologist for prostatitis, no care for post-vaccination effects.

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-22
Dose 4 — Moderna
2022-04-01
Survey response — 6 months, dose 3
MedDRA: Fatigue, Pain in extremity — Feeling: Good

Free text: Sore arm for several days, plus tiredness and fatigue for 2-3 days approximately one week after my most recent booster shot.

MedDRA releases: 2024-11 · check-in free text available
2022-09-15
Dose 5 — Moderna
2022-09-16
Survey response — days 1–6 daily, dose 5
MedDRA: Fatigue, Malaise — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: General feeling of tiredness and malaise

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-22
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-15
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-17
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-09-30	Moderna	No
4	2022-03-22	Moderna	No
5	2022-09-15	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Prostatitis.

Healthcare visit (other): Visited doctor in office

Release 10 — day 21, dose 3

2021-10-27

Symptoms: Prostatitis (during the summer, treated with anti-biotics and Tamsulosin). Sore arm for three days and general malaise for several says following 3rd covid shot.

Healthcare visit (other): Visited urologist for prostatitis, no care for post-vaccination effects.

Release 11 — 6 months, dose 3

2022-04-01

Symptoms: Sore arm for several days, plus tiredness and fatigue for 2-3 days approximately one week after my most recent booster shot.

Release 12 — days 1–6 daily, dose 5

2022-09-16

Systemic reaction (other): General feeling of tiredness and malaise

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	Prostatitis	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Prostatitis	✓	✓	✓
SD	Pyrexia	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Malaise	·	·	✓

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