ZDC-22646-74752

4 vaccinations 7 coded responses 38 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 959 / CA
Registered: 2021-03-10

Relationship: Self
Race: Multiracial
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

2021-03-09
Dose 1 — Moderna
2021-03-10
Registered in v-safe
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good · Site: Pain

Free text: some slight pain in my left armpit like lymph nodes, same arm as my shot

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

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Survey response — day 28, dose 1
MedDRA: Fatigue, Hypersensitivity, Pain, Rhinorrhoea — Feeling: Fair

Free text: Fatigue, body pains, runny nose, probably spring allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Dose 2 — Moderna
2021-04-07
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-08
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
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 28, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair

Free text: Fatigue, body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

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

Adult check-in
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Parosmia — Feeling: Good

Free text: Not sure if I reported this but I'm sensitive to a few smells including my hair gel, Dijon mustard, honey - they all have a moldy smell to me, slightly unpleasant.

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Dose 3 — Moderna
2022-04-07
Survey response — 12 months, dose 2
MedDRA: Oropharyngeal pain, Reflux laryngitis — Feeling: Good

Free text: Moderate persistent soreness in throat, diagnosed LPR (reflux disease)

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Dose 4 — Moderna
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-07
Survey response — day 35, dose 4
MedDRA: Fatigue — Feeling: Fair

Free text: Some moderate fatigue, did a self test today that was negative

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-01
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Good

Free text: COVID positive in June and COVID shot #5 bivalent in October

MedDRA releases: 2024-11 · check-in free text available
2023-05-05
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-07	Moderna
3	2021-11-21	Moderna	No
4	2022-05-03	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): some slight pain in my left armpit like lymph nodes, same arm as my shot

Release 7 — day 28, dose 1

2021-04-06

Symptoms: Fatigue, body pains, runny nose, probably spring allergies.

Release 8 — day 28, dose 2

2021-05-05

Symptoms: Fatigue, body aches

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Not sure if I reported this but I'm sensitive to a few smells including my hair gel, Dijon mustard, honey - they all have a moldy smell to me, slightly unpleasant.

Release 11 — 12 months, dose 2

2022-04-07

Symptoms: Moderate persistent soreness in throat, diagnosed LPR (reflux disease)

Release 11 — day 35, dose 4

2022-06-07

Symptoms: Some moderate fatigue, did a self test today that was negative

Release 12 — 6 months, dose 4

2022-11-01

Symptoms: COVID positive in June and COVID shot #5 bivalent in October

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	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Parosmia	·	·	✓
SD	Reflux laryngitis	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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