ZUA-32291-84094

2 vaccinations 11 coded responses 23 check-ins 11 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 750 / TX
Registered: 2020-12-28

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain

Free text: Light headed only

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-29
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Fatigue — Feeling: Fair · Site: Pain · Headache

Free text: W light headed and generally Fatigued after 8 hr rest w more pronounced after noon time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache — Feeling: Fair · Site: Swelling · Headache

Free text: Fatigue and small headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Joint pains, Muscle or body aches

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Loss of personal independence in daily activities, Office visit, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Possibly relay to Rheumatoid arthritis increased discomfort in ability to participate With my activities · Healthcare visit (other): Possibly increase rheumatoid arthritis discomfort related to immune suppression, will follow up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Related to the RA I believe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: I believe related to My Rheumatoid arthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — day 7, dose 1
MedDRA: Eye infection, Impaired work ability, Ocular discomfort, Pain, Rheumatoid arthritis, Specialist consultation — Feeling: Fair · Headache, Joint pains · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Eye infection w discomfort · Healthcare visit (other): Set up a follow up appointment with my attending. RA seems uncomfortable and more severe would you hydroxychloroquine and xeljanz auto immune Meds and increased soreness and difficulty Doing my job however muddling through it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-25
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Related to RA conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Poor · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Fatigue increased w work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Pain, Unevaluable event — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Generally fatigue early today w aches · Healthcare visit (other): Didnt keep a dr visit @ The VA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Survey response — day 14, dose 2
MedDRA: Cellulitis, Immunosuppression, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Infection cellulite of foot Immune suppressed after surgery, after getting the second dose, I considered not related · Healthcare visit (other): Veterans medical center

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-27	Moderna

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-28

Systemic reaction (other): Light headed only

Release 1 — days 1–6 daily, dose 1

2020-12-29

Systemic reaction (other): W light headed and generally Fatigued after 8 hr rest w more pronounced after noon time

2020-12-30

Systemic reaction (other): Fatigue and small headache

2021-01-01

Systemic reaction (other): Possibly relay to Rheumatoid arthritis increased discomfort in ability to participate With my activities

Healthcare visit (other): Possibly increase rheumatoid arthritis discomfort related to immune suppression, will follow up

2021-01-02

Systemic reaction (other): Related to the RA I believe

2021-01-03

Systemic reaction (other): I believe related to My Rheumatoid arthritis

Release 1 — day 7, dose 1

2021-01-04

Systemic reaction (other): Eye infection w discomfort

Healthcare visit (other): Set up a follow up appointment with my attending. RA seems uncomfortable and more severe would you hydroxychloroquine and xeljanz auto immune Meds and increased soreness and difficulty Doing my job however muddling through it

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Related to RA conditions

2021-02-01

Systemic reaction (other): Fatigue increased w work

2021-02-02

Systemic reaction (other): Generally fatigue early today w aches

Healthcare visit (other): Didnt keep a dr visit @ The VA

Release 4 — day 14, dose 2

2021-02-10

Symptoms: Infection cellulite of foot Immune suppressed after surgery, after getting the second dose, I considered not related

Healthcare visit (other): Veterans medical center

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
HCVO	Impaired work ability	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pain	✓	✓	✓
HCVO	Rheumatoid arthritis	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Cellulitis	✓	✓	✓
SD	Immunosuppression	✓	✓	✓
SRO	Condition aggravated	○	○	○
SRO	Dizziness	✓	✓	✓
SRO	Eye infection	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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