6WB-17476-52312

2 vaccinations 8 coded responses 12 check-ins 8 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 864 / AZ
Registered: 2021-02-11

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

2021-02-10
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Headache, Muscle or body aches

Free text: Wake up to headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — day 7, dose 1
MedDRA: SARS-CoV-2 test — Feeling: Fair · None · Get care from a doctor or other healthcare professional

Free text: Covid 19 tested due to contact with relative p

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Dose 2 — Moderna
2021-03-10
Survey response — day 0, dose 2
MedDRA: Balance disorder, Disorientation, Dyspnoea, Lacrimation increased, Somnolence — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Wet eyes,tears, sleepy ,disorietad, unsteady balance, shotness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Muscle spasms, Myalgia — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Painfull muscle spazims every 2 min & not,able to sleep for,18 hrs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Am headaches r bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Headache, Joint pains · Be unable to work, Be unable to do your normal daily activities

Free text: These r not from covid19 shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 2
MedDRA: Neck pain — Feeling: Good · Headache · Be unable to work

Free text: Same neck pain,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-06
Call 1 — Could Not Reach Participant
2021-08-11
Call 2 — Left Voicemail
2021-09-10
Survey response — 6 months, dose 2
MedDRA: Cardiac operation, Coronary arterial stent insertion, Emergency care, Hypertension, Unevaluable event — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: High Bp, ambulance to er. Get syens put in @ more to get in soon to my arteries . W bp w to high to to low du too blockage · Healthcare visit (other): Surgwry heart

MedDRA releases: 2024-11 · check-in free text available
2021-09-10
Report sent to call center — 6 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

1 call case(s)
2021-09-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-10	Moderna

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Wake up to headaches

Release 4 — day 7, dose 1

2021-02-17

Healthcare visit (other): Covid 19 tested due to contact with relative p

Release 5 — day 0, dose 2

2021-03-10

Systemic reaction (other): Wet eyes,tears, sleepy ,disorietad, unsteady balance, shotness of breath.

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Painfull muscle spazims every 2 min & not,able to sleep for,18 hrs

2021-03-15

Systemic reaction (other): Am headaches r bad

2021-03-16

Systemic reaction (other): These r not from covid19 shot

Release 5 — day 7, dose 2

2021-03-17

Systemic reaction (other): Same neck pain,

Release 9 — 6 months, dose 2

2021-09-10

Symptoms: High Bp, ambulance to er. Get syens put in @ more to get in soon to my arteries . W bp w to high to to low du too blockage

Healthcare visit (other): Surgwry heart

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	Cardiac operation	·	·	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	Emergency care	·	·	✓
SD	Hypertension	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Balance disorder	✓	✓	✓
SRO	Disorientation	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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