ZQY-99903-77657

4 vaccinations 6 coded responses 40 check-ins 6 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 070 / NJ
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 1
MedDRA: Injection site pruritus — Feeling: Good

Free text: Mild itchiness at the site of injection. This happened the evening after drinking alcohol (about two days after no symptoms) then gradually subsided.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to work

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Neuralgia, Pain in extremity — Feeling: Fair · Site: Redness

Free text: Nerve pain in right hand of arm where I got my shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 2
MedDRA: Neuralgia — Feeling: Good · Site: Redness, Itching

Free text: Nerve pain in hand of arm with injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-09
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache — Feeling: Good

Free text: Headache and tiredness for two days. This may be because of resuming more normal activities, if by chance I had been exposed to the virus, the feeling was very similar to receiving the first shot. However symptoms did not warrant a COVID test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Survey response — 3 months, dose 3
MedDRA: Headache, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, headache

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Dose 4 — Pfizer-BioNTech
2022-04-22
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-04-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-10
Survey response — 6 months, dose 4
MedDRA: Abdominal discomfort — Feeling: Good

Free text: Gastrointestinal distress

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna
3	2021-10-22	Moderna	No
4	2022-04-09	Pfizer-BioNTech	No

Free text

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Mild itchiness at the site of injection. This happened the evening after drinking alcohol (about two days after no symptoms) then gradually subsided.

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Nerve pain in right hand of arm where I got my shot

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Nerve pain in hand of arm with injection

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Headache and tiredness for two days. This may be because of resuming more normal activities, if by chance I had been exposed to the virus, the feeling was very similar to receiving the first shot. However symptoms did not warrant a COVID test.

Release 11 — 3 months, dose 3

2022-01-23

Symptoms: Sore throat, headache

Release 12 — 6 months, dose 4

2022-10-10

Symptoms: Gastrointestinal distress

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	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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