6W9-18942-76972

4 vaccinations 12 coded responses 29 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 750 / TX
Registered: 2021-02-20

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-24
Dose 1 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-28
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Fatigue — Feeling: Good

Free text: Feeling weak and tired during the day after the shot. After 2 days, back to normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Cold sweat — Feeling: Good · Chills

Free text: Had a cold sweat last night. But temperatures were fine after waking up at 98.5F.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 7, dose 2
MedDRA: Night sweats — Feeling: Good · Fever

Free text: Just had minor sweat at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-27
Survey response — day 21, dose 2
MedDRA: Asthenia, Cough, Frontal sinus operation, Seasonal allergy — Feeling: Poor · Be unable to do your normal daily activities

Free text: Probably having bad allergy due to high pollens and mild in (b)(6) area. Feeling weak with occasional coughing, but no fever. Since I had bad sinus drainage, I think it wont be related to COVID-19 type of syndrome.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — 3 months, dose 2
MedDRA: Asthma, Hypersensitivity, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Having asthma triggered by allergic reaction due to high pollens in mid May. But it is under control now and it is back to normal. · Healthcare visit (other): Family doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia, Body temperature increased, Diarrhoea, Fatigue, Pyrexia — Feeling: Fair · Diarrhea

Free text: 1st day (10/22) had fever of 100.6F, felt fatigue; 2nd Day (10/23): 99.6F, felt weak, diarrhea; 3rd Day (10/24) 99+F temperature, no arm sore, feeling much better.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — day 7, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Fatigue or tiredness, Diarrhea

Free text: A bit loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-04-01
Call 1 — Left Voicemail
2022-04-14
Dose 4 — Moderna
2022-04-14
Survey response — day 0, dose 4
MedDRA: Pain in extremity, Self-medication — Feeling: Good · Site: Swelling

Free text: Arm was quite sore the night after vaccination. The 2nd day I took a Tylernol. 80% of he arm soreness is gone by 2nd day dinner time. is gone

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Survey response — days 1–6 daily, dose 4
MedDRA: Blood pressure increased, Unevaluable event — Feeling: Good · Site: Pain

Free text: Blood pressure is lower back to normal. So are the temperatures.

MedDRA releases: 2024-11 · check-in free text available
2022-04-16
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: None.

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-18
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Good

Free text: Back to 100% normal.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: None

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-24	Moderna
2	2021-03-04	Moderna
3	2021-10-22	Moderna	No
4	2022-04-14	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Feeling weak and tired during the day after the shot. After 2 days, back to normal.

2021-03-10

Systemic reaction (other): Had a cold sweat last night. But temperatures were fine after waking up at 98.5F.

Release 5 — day 7, dose 2

2021-03-11

Systemic reaction (other): Just had minor sweat at night

Release 6 — day 21, dose 2

2021-03-27

Symptoms: Probably having bad allergy due to high pollens and mild in (b)(6) area. Feeling weak with occasional coughing, but no fever. Since I had bad sinus drainage, I think it wont be related to COVID-19 type of syndrome.

redacted (b)(6)

Release 8 — 3 months, dose 2

2021-06-03

Symptoms: Having asthma triggered by allergic reaction due to high pollens in mid May. But it is under control now and it is back to normal.

Healthcare visit (other): Family doctor visit

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): 1st day (10/22) had fever of 100.6F, felt fatigue; 2nd Day (10/23): 99.6F, felt weak, diarrhea; 3rd Day (10/24) 99+F temperature, no arm sore, feeling much better.

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): A bit loss of appetite

Release 11 — day 0, dose 4

2022-04-14

Systemic reaction (other): Arm was quite sore the night after vaccination. The 2nd day I took a Tylernol. 80% of he arm soreness is gone by 2nd day dinner time. is gone

Release 11 — days 1–6 daily, dose 4

2022-04-15

Systemic reaction (other): Blood pressure is lower back to normal. So are the temperatures.

2022-04-16

Systemic reaction (other): None.

2022-04-18

Systemic reaction (other): Back to 100% normal.

2022-04-19

Systemic reaction (other): None

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	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Frontal sinus operation	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Seasonal allergy	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Blood pressure increased	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Cold sweat	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Unevaluable event	·	·	✓

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