Z2R-11062-09788

4 vaccinations 8 coded responses 37 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 481 / MI
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Upper arm sore where injection was

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Injection site pain — Feeling: Good · Site: Pain

Free text: Pain very mild at point of injection. Fatigue has passed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: No symptoms

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

Free text: Feel great

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: Feel good; no effects from injection

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

Adult check-in
2021-03-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · 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 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
2022-04-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-16
Dose 4 — Moderna
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-18
Survey response — days 1–6 daily, dose 4
MedDRA: Discomfort, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: I had far less discomfort from this 4th (most recent) dose.

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-24
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-30
Survey response — day 14, dose 4
MedDRA: Headache, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Bad headache 24 hrs .Most likely due to stormy weather/ cold front as I suffered migraines since grade school (Im 67 now) Migraines stopped aorx 5 years aho so this wasnt expected

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-16
Survey response — 3 months, dose 4
MedDRA: Influenza like illness, Pain, Pyrexia, Vomiting — Feeling: Poor · Be unable to work or attend school

Free text: Flu like symptoms such as throwing up, fever and body aches

MedDRA releases: 2024-11 · check-in free text available
2023-03-20
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2021-12-10	Moderna	No
4	2022-09-16	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Upper arm sore where injection was

2021-03-10

Systemic reaction (other): Pain very mild at point of injection. Fatigue has passed

2021-03-11

Systemic reaction (other): No symptoms

2021-03-12

Systemic reaction (other): Feel great

2021-03-13

Systemic reaction (other): Feel good; no effects from injection

Release 12 — days 1–6 daily, dose 4

2022-09-18

Systemic reaction (other): I had far less discomfort from this 4th (most recent) dose.

Release 12 — day 14, dose 4

2022-09-30

Symptoms: Bad headache 24 hrs .Most likely due to stormy weather/ cold front as I suffered migraines since grade school (Im 67 now) Migraines stopped aorx 5 years aho so this wasnt expected

Release 12 — 3 months, dose 4

2022-12-16

Symptoms: Flu like symptoms such as throwing up, fever and body aches

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	Headache	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Vomiting	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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