YTG-50774-41745

3 vaccinations 11 coded responses 27 check-ins 11 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 229 / VA
Registered: 2021-04-10

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

2021-03-06
Dose 1 — Moderna
2021-04-10
Registered in v-safe
2021-04-10
Survey response — day 35, dose 1
MedDRA: Chills, Cough, Headache, Immunisation reaction, Muscular weakness, Myalgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Bad reaction to first vaccine, headache, chills, severe muscle ackes and weakness, deep cough. All this started on day two out, and continued for about 10 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Dose 2 — Moderna
2021-04-17
Survey response — day 0, dose 2
MedDRA: Chest discomfort — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Slight chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Abdominal pain

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Tinnitus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Tinitus worse than normal, a little unstable when moving

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Good · Abdominal pain

Free text: Tinitus worse than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Poor · Muscle or body aches, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Very weak,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — day 35, dose 2
MedDRA: Muscular weakness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Have experienced extreme weakness in legs. Not so bad today, was very uncomfortable earlier in the week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Asthenia, Brain fog, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very low energy, very weak in the legs. Seems a little brain fog. Other than that situation status quo.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Cough, Pain, Pyrexia — Feeling: Good

Free text: Cough, low grade fever, body pains

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Dose 3 — Moderna
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Balance disorder, Dizziness — Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Free text: Light headed, a little unstable

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-29
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-15
Survey response — day 21, dose 3
MedDRA: Abdominal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very bad stomach discomfort, may not be related to vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-17	Moderna
3	2021-11-22	Moderna	No

Free text

Release 7 — day 35, dose 1

2021-04-10

Symptoms: Bad reaction to first vaccine, headache, chills, severe muscle ackes and weakness, deep cough. All this started on day two out, and continued for about 10 days

Release 7 — day 0, dose 2

2021-04-17

Systemic reaction (other): Slight chest discomfort

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): Tinitus worse than normal, a little unstable when moving

2021-04-22

Systemic reaction (other): Tinitus worse than usual

2021-04-23

Systemic reaction (other): Very weak,

Release 8 — day 35, dose 2

2021-05-22

Symptoms: Have experienced extreme weakness in legs. Not so bad today, was very uncomfortable earlier in the week

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: Very low energy, very weak in the legs. Seems a little brain fog. Other than that situation status quo.

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Cough, low grade fever, body pains

Release 10 — days 1–6 daily, dose 3

2021-11-24

Systemic reaction (other): Chest discomfort

2021-11-26

Systemic reaction (other): Light headed, a little unstable

Release 10 — day 21, dose 3

2021-12-15

Symptoms: Very bad stomach discomfort, may not be related to vaccine.

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 discomfort	·	·	✓
SD	Asthenia	·	·	✓
SD	Brain fog	·	·	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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