YWH-16020-74915

4 vaccinations 8 coded responses 24 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-02-02

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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Self-medication — Feeling: Good · Site: Pain · Headache

Free text: Headache lasted until I took an Advil tablet. Then I forgot about it. ALSO I went on a 2 mile walk (30 minutes), normal pace and distance for me. I felt different. It felt more difficult to expand my lungs. Not bad, just a new feeling. Finished fine but feeling was there the entire walk. After was back to normal feeling.

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

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Fatigue or tiredness

Free text: Took 2 naps today. Normal is one.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: Chest discomfort while trying to sleep last night,. Extended into late morning. Similar to tightness i felt during a walk in day after shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — day 7, dose 1
MedDRA: Chest discomfort — Feeling: Good · Muscle or body aches

Free text: Same chest tightness in the morning but less than yesterday,. And a faster recovery time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-23
Survey response — day 21, dose 1
MedDRA: Chest discomfort, Loss of personal independence in daily activities, Weight increased — Feeling: Good

Free text: More like changed. After first shot, Feb 2, I mentioned chest tightness during walks/stretching. That is all gone. I believe it was due to the shot. Also, I gained a few pounds initially. Now back to normal weight, i believe it was water retention.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-09
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Rash on back of neck. May not be from shot, but a never rash thing all the same.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Weight increased — Feeling: Good

Free text: Weight gain, about 3 pounds, like after the first shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-09-07
Survey response — 6 months, dose 2
MedDRA: Fatigue, Insomnia — Feeling: Good · Be unable to do your normal daily activities

Free text: Periodicly overly fatigued, but i have attributed that to difficulty sleeping. I do not think it is Covid or vaccine related.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Dose 3 — Moderna
2022-03-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-11
Dose 4 — Moderna
2022-04-25
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-09	Moderna
3	2021-10-28	Moderna	No
4	2022-04-11	Moderna	No

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Headache lasted until I took an Advil tablet. Then I forgot about it. ALSO I went on a 2 mile walk (30 minutes), normal pace and distance for me. I felt different. It felt more difficult to expand my lungs. Not bad, just a new feeling. Finished fine but feeling was there the entire walk. After was back to normal feeling.

2021-02-06

Systemic reaction (other): Took 2 naps today. Normal is one.

2021-02-08

Systemic reaction (other): Chest discomfort while trying to sleep last night,. Extended into late morning. Similar to tightness i felt during a walk in day after shot.

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Same chest tightness in the morning but less than yesterday,. And a faster recovery time.

Release 4 — day 21, dose 1

2021-02-23

Symptoms: More like changed. After first shot, Feb 2, I mentioned chest tightness during walks/stretching. That is all gone. I believe it was due to the shot. Also, I gained a few pounds initially. Now back to normal weight, i believe it was water retention. cut off by CDC

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Rash on back of neck. May not be from shot, but a never rash thing all the same.

2021-03-13

Systemic reaction (other): Weight gain, about 3 pounds, like after the first shot.

Release 9 — 6 months, dose 2

2021-09-07

Symptoms: Periodicly overly fatigued, but i have attributed that to difficulty sleeping. I do not think it is Covid or vaccine related.

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	Chest discomfort	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Weight increased	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Weight increased	✓	✓	✓

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