Y79-55183-71583

4 vaccinations 7 coded responses 38 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 801 / CO
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Arm was very sore yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: I received the vaccine on the 9th, became sick at 10:00 am on Sat until 7:00 today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea — Feeling: Good · Site: Redness · Nausea

Free text: Mild Nausea this morning, now its gone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 28, dose 2
MedDRA: Chills, Headache, Pain — Feeling: Good

Free text: Last night I had chills, severe body-aches, and a headache. I slept 12 hours then felt ok this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Chills, Fatigue, Headache — Feeling: Good · Site: Pain

Free text: The day after my booster I experienced Chils, Headache, Joint Pain,, Tiredness, it was gone 2; hrs later

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — day 7, dose 3
MedDRA: Feeling hot — Feeling: Fair

Free text: Felt hot for about 15 minutes

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Dose 4 — Moderna
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Chills, Dizziness, Headache, Malaise, Nausea, Pain, Rhinorrhoea — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I was ill for about 36 hours after receiving my 2nd booster on 04/09/2022. Chills, Nausea, Body Aches, Headache, Runny Nose, Dizziness.

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-08
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-09
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna
3	2021-10-25	Moderna	No
4	2022-04-09	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Arm was very sore yesterday

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): I received the vaccine on the 9th, became sick at 10:00 am on Sat until 7:00 today.

2021-04-12

Systemic reaction (other): Mild Nausea this morning, now its gone

Release 8 — day 28, dose 2

2021-05-07

Symptoms: Last night I had chills, severe body-aches, and a headache. I slept 12 hours then felt ok this morning.

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): The day after my booster I experienced Chils, Headache, Joint Pain,, Tiredness, it was gone 2; hrs later

Release 10 — day 7, dose 3

2021-11-01

Systemic reaction (other): Felt hot for about 15 minutes

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: I was ill for about 36 hours after receiving my 2nd booster on 04/09/2022. Chills, Nausea, Body Aches, Headache, Runny Nose, Dizziness.

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	Chills	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Chills	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Feeling hot	·	·	✓
SRO	Headache	·	·	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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