6NZ-23485-26128

2 vaccinations 5 coded responses 26 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 51-55
ZIP prefix: 933 / CA
Registered: 2021-03-31

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

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

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
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: Fair · Site: Pain · Fever · Fatigue or tiredness

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
2021-04-15
Health check-in — day 14, dose 1
Feeling: Fair

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

Adult check-in
2021-04-28
Dose 2 — Moderna
2021-04-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches · 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: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

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

Adult check-in
2021-05-12
Survey response — day 14, dose 2
MedDRA: Chest pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: I've had chest pain on my left side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 21, dose 2
MedDRA: Fatigue, Injection site rash, Throat irritation — Feeling: Fair

Free text: I've had a burning in my throat and I've noticed a rash at the injection site on my arm and I've been feeling more tired than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Fatigue, Lethargy, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: I find that I'm very tired and lethargic. I also find that I get winded easily after the second shot and I feel a burning sensastion in my throat when I try and run.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-09
Survey response — day 42, dose 2
MedDRA: Exercise tolerance decreased, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: I continue to have event's where I find it challenging to do extended Cardio vasular activities. ie. running.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-28
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-03
Survey response — 12 months, dose 2
MedDRA: Cerebrovascular accident — 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 · Emergency room or emergency department visit, Hospitalization

Free text: I had a stroke.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-04
Call 1 — Requested Callback
2022-05-06
Call 2 — Left Voicemail
2022-05-06
Callback requested for

Vaccinations

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

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 2

2021-05-12

Symptoms: I've had chest pain on my left side.

Release 8 — day 21, dose 2

2021-05-19

Symptoms: I've had a burning in my throat and I've noticed a rash at the injection site on my arm and I've been feeling more tired than usual

Release 8 — day 28, dose 2

2021-05-26

Symptoms: I find that I'm very tired and lethargic. I also find that I get winded easily after the second shot and I feel a burning sensastion in my throat when I try and run.

Release 9 — day 42, dose 2

2021-06-09

Symptoms: I continue to have event's where I find it challenging to do extended Cardio vasular activities. ie. running.

Release 11 — 12 months, dose 2

2022-05-03

Symptoms: I had a stroke.

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	Cerebrovascular accident	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Exercise tolerance decreased	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SD	Unevaluable event	✓	✓	○

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