Z6L-32302-15478

3 vaccinations 10 coded responses 25 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 949 / CA
Registered: 2021-04-16

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

2021-04-15
Dose 1 — Moderna
2021-04-16
Registered in v-safe
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain

Free text: I have some of these symptoms NOT related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain

Free text: I have some of these symptoms but not related to the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: I have some of these symptoms NOT related to the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort, Abdominal distension, Anxiety, Arthralgia, Asthenia, Dizziness, Dry mouth, Dry throat, Headache, Nausea, Pollakiuria — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headaches, anxiety, nausea, bloating, abdominal discomfort, dizziness, dryness in mouth and throat, frequent urination, weak, some joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-13
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have these symptoms normally and not related to the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Flushing, Paraesthesia — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tingly skin, lite flushing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Hot flush, Micturition urgency — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Heat flush through night associated with urgent urination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-20
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-27
Survey response — day 14, dose 2
MedDRA: Abdominal discomfort, Abdominal distension, Dizziness, Flatulence, Flushing, Hot flush, Muscle spasms, Nausea, Vomiting — Feeling: Poor

Free text: Abdominal/digestion discomfort: cramping, bloating, trapped gas, nausea, dizziness, flush face. Sudden heat flushing/nausea in the middle of the night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Dizziness, Flushing, Gastrointestinal sounds abnormal, Headache, Nausea, Pain, Palpitations, Photophobia, Pollakiuria, Tension headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Abdominal discomfort: gurgling, nausea, dizziness, pain, frequent urination. Headaches: flush face, tight forehead temples, heart pounding in the head, sensitive eyes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 3 months, dose 2
MedDRA: Anxiety, Flushing, Gastrointestinal disorder, Headache — Feeling: Fair

Free text: Ongoing flush face, headaches, digestive irregularity, anxiety. Symptoms come and go in surges that can last up to two weeks before they subside. Each wave seems liter.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-05
Dose 3 — Moderna
2022-07-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-07
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna
3	2022-01-05	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-16

Systemic reaction (other): I have some of these symptoms NOT related to the vaccine.

2021-04-17

Systemic reaction (other): I have some of these symptoms but not related to the vaccination.

2021-04-19

Systemic reaction (other): I have some of these symptoms NOT related to the vaccination.

Release 8 — day 14, dose 1

2021-04-29

Symptoms: Headaches, anxiety, nausea, bloating, abdominal discomfort, dizziness, dryness in mouth and throat, frequent urination, weak, some joint pain

Release 8 — day 0, dose 2

2021-05-13

Systemic reaction (other): I have these symptoms normally and not related to the vaccination.

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Tingly skin, lite flushing

2021-05-18

Systemic reaction (other): Heat flush through night associated with urgent urination.

Release 8 — day 14, dose 2

2021-05-27

Symptoms: Abdominal/digestion discomfort: cramping, bloating, trapped gas, nausea, dizziness, flush face. Sudden heat flushing/nausea in the middle of the night.

Release 8 — day 21, dose 2

2021-06-03

Symptoms: Abdominal discomfort: gurgling, nausea, dizziness, pain, frequent urination. Headaches: flush face, tight forehead temples, heart pounding in the head, sensitive eyes.

Release 9 — 3 months, dose 2

2021-08-12

Symptoms: Ongoing flush face, headaches, digestive irregularity, anxiety. Symptoms come and go in surges that can last up to two weeks before they subside. Each wave seems liter.

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	Abdominal distension	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dry mouth	✓	✓	✓
SD	Dry throat	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Flushing	✓	✓	✓
SD	Gastrointestinal disorder	✓	·	✓
SD	Gastrointestinal sounds abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Photophobia	✓	✓	✓
SD	Pollakiuria	✓	✓	✓
SD	Tension headache	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Micturition urgency	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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