YCH-10476-30511

3 vaccinations 18 coded responses 28 check-ins 19 free-text entries 0 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 530 / WI
Registered: 2021-04-03

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

2021-04-03
Registered in v-safe
2021-04-03
Dose 1 — Janssen/Johnson & Johnson
2021-04-03
Survey response — day 0, dose 1
MedDRA: Fatigue, Injection site paraesthesia, Skin warm — Feeling: Good · Site: Pain, Swelling · 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: TINGLING AT INJECTION SITE IMMEDIATELY, THEN HEAT ON LEFT ARM, THEN HEAT ON CHEST AND HEART, THEN HEAT ON RIBS, THEN MODERATE FATIGUE AND TIREDNESS

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: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, 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
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, 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
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, 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
2021-04-18
Survey response — day 14, dose 1
MedDRA: Chills, Fatigue, Headache, Peripheral swelling, Self-medication — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches, requiring Tylenol, swelling in left arm where shot was, tiredness, fatigue, chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 21, single dose
MedDRA: Arthralgia, Fatigue, Headache, Myalgia, Pain, Pain in extremity, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Mild swelling in vaccine shot left arm, severe headaches at times, fatigue and tiredness, moderate aches and pain in joints and muscles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 28, single dose
MedDRA: Arthralgia, Chills, Eye pruritus, Fatigue, Ocular hyperaemia, Secretion discharge — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, achy joints, tiredness and fatigue, red and itchy eyes with mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 35, single dose
MedDRA: Chills, Fatigue, Headache, Injection site swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, severe random headaches, swollen left arm where shot occurred, tiredness and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — day 42, single dose
MedDRA: Chills, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, severe headaches at random times during day still, pain at left arm shot area, fatigue and tiredness still

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
Survey response — 3 months, dose 1
MedDRA: Fatigue, Headache, Injection site pain, Ocular hyperaemia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and tiredness, severe headaches at random times throughout the day and night, pain in the left arm shot area, left and right eye redness and mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-02
Survey response — 6 months, dose 1
MedDRA: Eye discharge, Eye pruritus, Injection site paraesthesia, Ocular hyperaemia, Vaccination site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tingling at left arm vaccine shot area, sharp pain at the left arm vaccine shot area, red and itchy eyes with mucus about once to twice a week, wondering and thinking I require the booster as soon as possible for protection

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Dose 2 — Moderna
Co-administered: Flu
2021-10-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Survey response — day 14, dose 2
MedDRA: Arthralgia, Chills, Headache, Injection site pain, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Random chills, pain and joint aches, severe headaches, pain at shot in left arm area,

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 21, dose 2
MedDRA: Chills, Fatigue, Headache, Injection site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in left arm where booster shot location is, chills, fatigue and tiredness, headaches

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — day 28, dose 2
Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, fatigue and tiredness, pain in left arm shot area, severe headaches

Adult check-in · check-in free text available
2021-11-29
Survey response — day 35, dose 2
MedDRA: Chills, Fatigue, Headache, Injection site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, severe headaches, tiredness and fatigue, pain in the left arm where the shot was located

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Survey response — day 42, dose 2
MedDRA: Chills, Fatigue, Headache, Injection site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, severe headaches, pain in left arm where shot location is, fatigue and tiredness

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — 3 months, dose 2
MedDRA: Chills, Fatigue, Headache, Vaccination site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches, tiredness and fatigue, pain where vaccine shots are, and chills

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Survey response — 6 months, dose 2
MedDRA: Chills, Fatigue, Headache, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and tiredness, chills, fever, body aches and pains, and severe headaches

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Dose 3 — Moderna
2022-06-22
Survey response — day 35, dose 3
MedDRA: Arthralgia, Fatigue, Headache, Injection site pain, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and tiredness, pain in left arm at shot location, aching and joint pains, severe headaches

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Survey response — day 42, dose 3
MedDRA: Abdominal pain upper, Arthralgia, Fatigue, Headache, Injection site pain, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tiredness and fatigue, severe headaches, stomach ache, joints and muscle pains, and pain at left arm location where vaccine shot occurred

MedDRA releases: 2024-11 · check-in free text available
2022-08-13
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Fatigue, Headache, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and tiredness, headaches, muscle and joint pains

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — 6 months, dose 3
MedDRA: Fatigue, Injection site pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue, Tiredness, Left arm shot area soreness

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Janssen/Johnson & Johnson
2	2021-10-25	Moderna	Flu
3	2022-05-13	Moderna	No

Free text

Release 6 — day 0, dose 1

2021-04-03

Systemic reaction (other): TINGLING AT INJECTION SITE IMMEDIATELY, THEN HEAT ON LEFT ARM, THEN HEAT ON CHEST AND HEART, THEN HEAT ON RIBS, THEN MODERATE FATIGUE AND TIREDNESS

Release 7 — day 14, dose 1

2021-04-18

Symptoms: Headaches, requiring Tylenol, swelling in left arm where shot was, tiredness, fatigue, chills

Release 7 — day 21, single dose

2021-04-24

Symptoms: Mild swelling in vaccine shot left arm, severe headaches at times, fatigue and tiredness, moderate aches and pain in joints and muscles

Release 8 — day 28, single dose

2021-05-03

Symptoms: Chills, achy joints, tiredness and fatigue, red and itchy eyes with mucus

Release 8 — day 35, single dose

2021-05-09

Symptoms: Chills, severe random headaches, swollen left arm where shot occurred, tiredness and fatigue

Release 8 — day 42, single dose

2021-05-16

Symptoms: Chills, severe headaches at random times during day still, pain at left arm shot area, fatigue and tiredness still

Release 9 — 3 months, dose 1

2021-07-03

Symptoms: Fatigue and tiredness, severe headaches at random times throughout the day and night, pain in the left arm shot area, left and right eye redness and mucus

Release 9 — 6 months, dose 1

2021-10-02

Symptoms: Tingling at left arm vaccine shot area, sharp pain at the left arm vaccine shot area, red and itchy eyes with mucus about once to twice a week, wondering and thinking I require the booster as soon as possible for protection

Release 10 — day 14, dose 2

2021-11-08

Symptoms: Random chills, pain and joint aches, severe headaches, pain at shot in left arm area,

Release 10 — day 21, dose 2

2021-11-16

Symptoms: Pain in left arm where booster shot location is, chills, fatigue and tiredness, headaches

Release 10 — day 35, dose 2

2021-11-29

Symptoms: Chills, severe headaches, tiredness and fatigue, pain in the left arm where the shot was located

Release 10 — day 42, dose 2

2021-12-06

Symptoms: Chills, severe headaches, pain in left arm where shot location is, fatigue and tiredness

Release 11 — 3 months, dose 2

2022-01-25

Symptoms: Headaches, tiredness and fatigue, pain where vaccine shots are, and chills

Release 11 — 6 months, dose 2

2022-04-25

Symptoms: Fatigue and tiredness, chills, fever, body aches and pains, and severe headaches

Release 12 — day 28, dose 2

2021-11-23

Symptoms: Chills, fatigue and tiredness, pain in left arm shot area, severe headaches

Release 12 — day 35, dose 3

2022-06-22

Symptoms: Fatigue and tiredness, pain in left arm at shot location, aching and joint pains, severe headaches

Release 12 — day 42, dose 3

2022-06-25

Symptoms: Tiredness and fatigue, severe headaches, stomach ache, joints and muscle pains, and pain at left arm location where vaccine shot occurred

Release 12 — 3 months, dose 3

2022-08-13

Symptoms: Fatigue and tiredness, headaches, muscle and joint pains

Release 12 — 6 months, dose 3

2022-11-11

Symptoms: Fatigue, Tiredness, Left arm shot area soreness

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	Abdominal pain upper	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Eye discharge	·	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site paraesthesia	·	·	✓
SD	Injection site swelling	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Secretion discharge	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Vaccination site pain	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site paraesthesia	✓	✓	✓
SRO	Skin warm	✓	✓	✓

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