6S9-57214-34668

3 vaccinations 14 coded responses 27 check-ins 14 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 786 / TX
Registered: 2020-12-31

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Sleep disorder — Feeling: Fair · Site: Pain · Headache, Joint pains · Be unable to do your normal daily activities

Free text: Shot at 5pm, at 3am awaken with painful headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Libido decreased, Nausea — Feeling: Good · Joint pains, Fatigue or tiredness, Nausea

Free text: Libido is almost non existent. I forgot that my nausa occurs in the evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Flatulence, Loss of libido — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches

Free text: No libido, gassy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-30
Dose 2 — Moderna
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Cough, Dyspnoea, Myalgia, Taste disorder — Feeling: Poor · Site: Pain, Redness · Fever · Chills, 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: Overall completely muscle joint pain. Coughing where i tasted blood only yhe morning. Short breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Intermittent hacking cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Hacking cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-06
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Still with hacking dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-27
Survey response — day 28, dose 2
MedDRA: Anxiety, Depression — Feeling: Fair · Be unable to work

Free text: Treated for depression and anxiety. Rx prescribed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 35, dose 2
MedDRA: Depression — Feeling: Poor · Be unable to do your normal daily activities

Free text: Depression. Prescribed Sertraline, 100mg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 42, dose 2
MedDRA: Anxiety, Depression — Feeling: Poor

Free text: Depression and anxiety that i am taking antidepression medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2021-07-24
Dose 3 — Moderna
2021-07-31
Survey response — 6 months, dose 2
MedDRA: Eye infection, Infection — Feeling: Fair

Free text: Recurring eye infection.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-24
Survey response — 3 months, dose 3
MedDRA: Asthenia, Fatigue, Memory impairment — Feeling: Good

Free text: Memory issues. Fatigue. Low energy.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Survey response — 6 months, dose 3
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tested positive for Covid on jan. 9th and restested on 13th, 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-07-24
Survey response — 12 months, dose 3
MedDRA: Cough, Memory impairment, Throat irritation — Feeling: Good

Free text: Just some slight coughing, scratch throat, sometimes some forgetfulness. Overall i guess okay.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-30	Moderna
3	2021-07-24	Moderna	No

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Shot at 5pm, at 3am awaken with painful headache.

2021-01-03

Systemic reaction (other): Libido is almost non existent. I forgot that my nausa occurs in the evening.

2021-01-04

Systemic reaction (other): No libido, gassy.

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Overall completely muscle joint pain. Coughing where i tasted blood only yhe morning. Short breath.

2021-02-02

Systemic reaction (other): Intermittent hacking cough.

2021-02-03

Systemic reaction (other): Hacking cough

Release 3 — day 7, dose 2

2021-02-06

Systemic reaction (other): Still with hacking dry cough

Release 4 — day 28, dose 2

2021-02-27

Symptoms: Treated for depression and anxiety. Rx prescribed.

Release 5 — day 35, dose 2

2021-03-06

Symptoms: Depression. Prescribed Sertraline, 100mg.

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Depression and anxiety that i am taking antidepression medication.

Release 9 — 6 months, dose 2

2021-07-31

Symptoms: Recurring eye infection.

Release 10 — 3 months, dose 3

2021-10-24

Symptoms: Memory issues. Fatigue. Low energy.

Release 11 — 6 months, dose 3

2022-01-22

Symptoms: Tested positive for Covid on jan. 9th and restested on 13th, 2022.

Release 12 — 12 months, dose 3

2022-07-24

Symptoms: Just some slight coughing, scratch throat, sometimes some forgetfulness. Overall i guess okay.

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	Anxiety	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Depression	✓	✓	✓
SD	Eye infection	✓	·	✓
SD	Fatigue	·	·	✓
SD	Infection	✓	·	✓
SD	Memory impairment	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Libido decreased	✓	✓	✓
SRO	Loss of libido	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Taste disorder	✓	✓	✓

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