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ZML-24967-69368

3 vaccinations 7 coded responses 25 check-ins 7 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
930 / CA
Registered
2021-03-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-12
    Dose 1 — Moderna
  2. 2021-03-12
    Dose 2 — Moderna
  3. 2021-03-13
    Registered in v-safe
  4. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-03-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea
    Free text: Light headed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  7. 2021-03-19
    Health check-in — day 7, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  8. 2021-03-26
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  9. 2021-04-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-04-09
    Survey response — day 28, dose 2
    MedDRA: Fatigue — Feeling: Fair
    Free text: Fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-16
    Survey response — day 35, dose 2
    MedDRA: Chills, Fatigue — Feeling: Fair
    Free text: Fatigue and chills
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-23
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-06-11
    Health check-in — 3 months, dose 2
    Feeling: Poor
    Adult check-in
  14. 2021-09-12
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  15. 2021-10-30
    Dose 3 — Moderna
  16. 2021-10-30
    Health check-in — day 0, dose 3
    Feeling: Fair · None
    Adult check-in
  17. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  18. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  19. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  20. 2021-11-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  21. 2021-11-07
    Health check-in — day 7, dose 3
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  22. 2021-11-13
    Health check-in — day 14, dose 3
    Feeling: Fair
    Adult check-in
  23. 2021-11-22
    Survey response — day 21, dose 3
    MedDRA: Depression, Fatigue, Nasal congestion — Feeling: Poor
    Free text: Fatigue, depression, stuffy nose.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2021-11-29
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  25. 2021-12-04
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  26. 2021-12-11
    Survey response — day 42, dose 3
    MedDRA: Anxiety, Asthenia, Depressed mood, Dizziness, Nasal congestion — Feeling: Fair
    Free text: Stuffy nose in the mornings, very low energy, light headed, depressed and anxious.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-01-29
    Survey response — 3 months, dose 3
    MedDRA: Cough, Fatigue, Nasal congestion, SARS-CoV-2 test negative, Sneezing — Feeling: Fair
    Free text: Stuffy nose, sneezing, some coughing and very tired. I was concerned I might have Covid so got PCR test at (b)(6) and it was negative. Figure I got a nasty cold.
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-05-05
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  29. 2022-11-01
    Survey response — 12 months, dose 3
    MedDRA: Fear, Pre-existing disease, Tinnitus — Feeling: Fair
    Free text: Possible mild cold. I also have developed tinnitus which started a couple years ago which I think came after I got the Covid 19 vaccination. I am now afraid to get the second booster because of the severity of the tinnitus.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-12Moderna
22021-03-12Moderna
32021-10-30Moderna No

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Light headed

Release 7 — day 28, dose 2

2021-04-09

Symptoms: Fatigue

Release 7 — day 35, dose 2

2021-04-16

Symptoms: Fatigue and chills

Release 10 — day 21, dose 3

2021-11-22

Symptoms: Fatigue, depression, stuffy nose.

Release 10 — day 42, dose 3

2021-12-11

Symptoms: Stuffy nose in the mornings, very low energy, light headed, depressed and anxious.

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Stuffy nose, sneezing, some coughing and very tired. I was concerned I might have Covid so got PCR test at (b)(6) and it was negative. Figure I got a nasty cold.
redacted (b)(6)

Release 12 — 12 months, dose 3

2022-11-01

Symptoms: Possible mild cold. I also have developed tinnitus which started a couple years ago which I think came after I got the Covid 19 vaccination. I am now afraid to get the second booster because of the severity of the tinnitus.

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

FieldPreferred term2021-092023-042024-11
SDAnxiety · · ✓
SDAsthenia · · ✓
SDChills ✓ ✓ ✓
SDCough · · ✓
SDDepressed mood · · ✓
SDDepression · · ✓
SDDizziness · · ✓
SDFatigue ✓ ✓ ✓
SDFear · · ✓
SDNasal congestion · · ✓
SDPre-existing disease · · ✓
SDSARS-CoV-2 test negative · · ✓
SDSneezing · · ✓
SDTinnitus · · ✓
SRODizziness ✓ ✓ ✓

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