6VH-23182-74629

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

Sex: Male
Age at first dose: 31-35
ZIP prefix: 939 / CA
Registered: 2021-03-24

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

2021-03-23
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Immediate post-injection reaction, Tongue pruritus — Feeling: Good · Site: Pain, Redness

Free text: Yesterday after I got the shot, about 30min later my tongue was a little itchy. Wasnt swollen or anything but just slightly itchy. Went away after about an hour and Ive been fine since.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Survey response — day 14, dose 1
MedDRA: Headache, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling — Feeling: Good

Free text: Starting mid last week I experienced swelling, soreness, a rash, and itching at the injection area. It all went away after a few days. Still getting random headaches but I dont know if related. Could be stress.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-20
Dose 2 — Moderna
2021-04-20
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 35, dose 2
MedDRA: Chest discomfort, Chest pain, Eructation — Feeling: Fair

Free text: Ive been feeling pressure/slight pain in chest for the last week or so. Feeling alternates to different parts of my chest but always near pectoral. Sometimes right or left. Trying to set appt with Primary care Doctor.Also burping a lot more.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Chest pain, Cough, Emergency care, Eructation, Flatulence — Feeling: Fair

Free text: Been having intermittent chest pain/pressure. Went to ER, no sign of heart attack. Was advised to schedule a cardiac stress test. Also feeling very gassy and burping a lot. Might be related, not sure.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Chest discomfort, Chest pain, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: I was having chest pains/pressure. Got checked out and they don't see anything wrong with my heart. Symptoms go away/get better with Pepcid. · Healthcare visit (other): Also cardiologist appointments afterwards

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-10-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-11
Dose 3 — Moderna
2022-04-22
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-12-11
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Moderna
2	2021-04-20	Moderna
3	2021-12-11	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Yesterday after I got the shot, about 30min later my tongue was a little itchy. Wasnt swollen or anything but just slightly itchy. Went away after about an hour and Ive been fine since.

Release 7 — day 14, dose 1

2021-04-06

Symptoms: Starting mid last week I experienced swelling, soreness, a rash, and itching at the injection area. It all went away after a few days. Still getting random headaches but I dont know if related. Could be stress.

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Ive been feeling pressure/slight pain in chest for the last week or so. Feeling alternates to different parts of my chest but always near pectoral. Sometimes right or left. Trying to set appt with Primary care Doctor.Also burping a lot more.

Release 8 — day 42, dose 2

2021-06-01

Symptoms: Been having intermittent chest pain/pressure. Went to ER, no sign of heart attack. Was advised to schedule a cardiac stress test. Also feeling very gassy and burping a lot. Might be related, not sure.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: I was having chest pains/pressure. Got checked out and they don't see anything wrong with my heart. Symptoms go away/get better with Pepcid.

Healthcare visit (other): Also cardiologist appointments afterwards

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	Unevaluable event	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Eructation	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Tongue pruritus	✓	✓	✓

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