6W4-21399-58206

4 vaccinations 16 coded responses 55 check-ins 16 free-text entries 0 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 941 / CA
Registered: 2021-03-29

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

2021-03-29
Registered in v-safe
2021-03-29
Dose 1 — Moderna
2021-03-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Good · Site: Pain

Free text: Heart palpitations (less than 5 minutes)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema — Feeling: Good · Fever · Fatigue or tiredness

Free text: Small red spots on toes, both feet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Rash macular — Feeling: Good

Free text: Red spots on toes, both feet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema — Feeling: Good

Free text: Red spots on toes, both feet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Moderna
2021-04-26
Health check-in — day 0, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Immunisation reaction — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Covid Toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Covid Toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Covid Toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 7, dose 2
MedDRA: Immunisation reaction — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Covid toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 21, dose 2
MedDRA: Chest discomfort, Diarrhoea, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Anout 10 days of unexplains runny stools. Also heavy chest congestion for a week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — day 28, dose 2
MedDRA: Erythema, Immunisation reaction, Pain in extremity — Feeling: Good

Free text: Covid toes flare up, and additionally soreness/redness on the bottoms of both feet for about 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-26
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-12-16
Dose 3 — Moderna
Co-administered: Flu
2021-12-16
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Eye pruritus, Lacrimation increased, Night sweats, Sneezing — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Night sweats, sneezing, watery/itchy eyes

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — days 1–6 daily, dose 3
MedDRA: Night sweats — Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Free text: Night sweats

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Survey response — days 1–6 daily, dose 3
MedDRA: Night sweats — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Night sweats

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-16
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-12-16
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-12-16
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-12-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-12-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2022-12-19
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion, Sneezing — Feeling: Good · Site: Pain · Joint pains

Free text: Congestion and sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Continued chest congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Good · Nausea, Diarrhea

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-12-23
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2023-01-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-16
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-29	Moderna
2	2021-04-26	Moderna
3	2021-12-16	Moderna	Flu
4	2022-12-16	Pfizer-BioNTech	Flu

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): Heart palpitations (less than 5 minutes)

2021-04-01

Systemic reaction (other): Small red spots on toes, both feet.

2021-04-02

Systemic reaction (other): Red spots on toes, both feet.

2021-04-03

Systemic reaction (other): Red spots on toes, both feet.

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Covid Toes

2021-05-01

Systemic reaction (other): Covid Toes

2021-05-02

Systemic reaction (other): Covid Toes

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): Covid toes

Release 8 — day 21, dose 2

2021-05-17

Symptoms: Anout 10 days of unexplains runny stools. Also heavy chest congestion for a week.

Release 8 — day 28, dose 2

2021-05-24

Symptoms: Covid toes flare up, and additionally soreness/redness on the bottoms of both feet for about 3 days.

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Night sweats, sneezing, watery/itchy eyes

2021-12-18

Systemic reaction (other): Night sweats

2021-12-19

Systemic reaction (other): Night sweats

Release 12 — days 1–6 daily, dose 4

2022-12-19

Systemic reaction (other): Congestion and sneezing

2022-12-20

Systemic reaction (other): Continued chest congestion.

2022-12-21

Systemic reaction (other): Congestion

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	Chest discomfort	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pruritus	·	·	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Lacrimation increased	·	·	✓
SRO	Night sweats	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Sneezing	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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