ZAW-20982-58082

5 vaccinations 20 coded responses 46 check-ins 19 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 967 / HI
Registered: 2021-03-05

Relationship: Self
Race: Asian
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

2021-03-04
Dose 1 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Atrial flutter, Cardiac flutter, Dysgeusia — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: Yesterday after my shot and during my 15 minutes wait time, I experienced a slight fluttering of my heart and a an unusual metallic/sour taste at the back of my tongue. The nurse suggested I drink water and it went away (the weird taste), but came back again about 20 minutes later after I returned to work. It eventually subsided (the unusual taste and heart fluttering).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: Im feeling normal so I resumed my workout routines.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia — Feeling: Good · Fever

Free text: Not at 100% energy level...I would say about at 90%

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

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety — Feeling: Fair

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 7, dose 1
MedDRA: Anxiety, Feeling abnormal — Feeling: Good

Free text: Good day today, less anxiety or brain farts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Survey response — day 0, dose 2
MedDRA: Dysgeusia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Metallic/Sour taste on the tip of my tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Feels like moderate flu symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Wheezing — Feeling: Good

Free text: Wheezing cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — day 7, dose 2
MedDRA: Flatulence — Feeling: Good

Free text: Gastrointestinal Gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Acne, Headache, Neck pain, Oral herpes — Feeling: Good

Free text: Acne or cold sores at the corner of my right eye and left corner of my mouth that comes and goes every two weeks or so....could it be viral? Also, I have developed neck pain that is sometimes accompanied by a head ache. Anybody else reported?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Oral herpes, Rhinorrhoea — Feeling: Fair

Free text: Runny nose, cold sores

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Dose 3 — Moderna
2022-04-03
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-29
Dose 4 — Moderna
2022-05-05
Survey response — days 1–6 daily, dose 4
MedDRA: Productive cough, Pulmonary pain — Feeling: Fair · Muscle or body aches

Free text: My right lung hurts and have moderate flem

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 7, dose 4
MedDRA: Nasal herpes, Productive cough, Pulmonary pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cold sore in my right nostril, pain in my lower right lung, a little phlegm or sputum

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-22
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-27
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-03
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-12
Survey response — day 42, dose 4
MedDRA: Nasal congestion, Nasopharyngitis — Feeling: Poor

Free text: A mild head cold, stuffy nose, but no fever.

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Survey response — 3 months, dose 4
MedDRA: Neuralgia, Sciatica — Feeling: Fair · Be unable to do your normal daily activities

Free text: sciatica and or nerve related pains at various body locations

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Dose 5 — Moderna
Co-administered: Flu
2022-09-28
Health check-in — day 0, dose 5
Feeling: Fair · None

Adult check-in
2022-09-29
Survey response — days 1–6 daily, dose 5
MedDRA: Oral herpes — Feeling: Fair · Site: Pain · Fever · Muscle or body aches

Free text: Cold sore

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog — Feeling: Fair · Site: Redness · Muscle or body aches

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2022-10-07
Survey response — day 7, dose 5
MedDRA: Oral herpes, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Cold sore again in right nostril at the same place after previous Covid vaccinations.

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-19
Survey response — day 21, dose 5
MedDRA: Cough, Fatigue, Wheezing — Feeling: Fair

Free text: Fatigue and wheezing cough.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-02
Survey response — 6 months, dose 5
MedDRA: Lower respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-11-12	Moderna	No
4	2022-04-29	Moderna	No
5	2022-09-28	Moderna	Flu

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Yesterday after my shot and during my 15 minutes wait time, I experienced a slight fluttering of my heart and a an unusual metallic/sour taste at the back of my tongue. The nurse suggested I drink water and it went away (the weird taste), but came back again about 20 minutes later after I returned to work. It eventually subsided (the unusual taste and heart fluttering).

2021-03-06

Systemic reaction (other): Im feeling normal so I resumed my workout routines.

2021-03-07

Systemic reaction (other): Not at 100% energy level...I would say about at 90%

2021-03-10

Systemic reaction (other): Anxiety

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Good day today, less anxiety or brain farts

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): Metallic/Sour taste on the tip of my tongue

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Feels like moderate flu symptoms

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Wheezing cough

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Gastrointestinal Gas

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Acne or cold sores at the corner of my right eye and left corner of my mouth that comes and goes every two weeks or so....could it be viral? Also, I have developed neck pain that is sometimes accompanied by a head ache. Anybody else reported?

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Runny nose, cold sores

Release 11 — days 1–6 daily, dose 4

2022-05-05

Systemic reaction (other): My right lung hurts and have moderate flem

Release 11 — day 7, dose 4

2022-05-06

Systemic reaction (other): Cold sore in my right nostril, pain in my lower right lung, a little phlegm or sputum

Release 12 — day 42, dose 4

2022-06-12

Symptoms: A mild head cold, stuffy nose, but no fever.

Release 12 — 3 months, dose 4

2022-07-29

Symptoms: sciatica and or nerve related pains at various body locations

Release 12 — days 1–6 daily, dose 5

2022-09-29

Systemic reaction (other): Cold sore

2022-09-30

Systemic reaction (other): Brain fog

Release 12 — day 7, dose 5

2022-10-07

Systemic reaction (other): Cold sore again in right nostril at the same place after previous Covid vaccinations.

Release 12 — day 21, dose 5

2022-10-19

Symptoms: Fatigue and wheezing cough.

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	Acne	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Neuralgia	·	·	✓
SD	Oral herpes	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sciatica	·	·	✓
SD	Wheezing	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Atrial flutter	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Cardiac flutter	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Nasal herpes	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Oral herpes	·	·	✓
SRO	Productive cough	·	·	✓
SRO	Pulmonary pain	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Wheezing	✓	✓	✓

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