ZUM-92790-75382

4 vaccinations 13 coded responses 27 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 613 / IL
Registered: 2021-02-22

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

2021-02-21
Dose 1 — Moderna
2021-02-22
Registered in v-safe
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · Headache, Joint pains

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Headache, Diarrhea

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Headache, Joint pains, Diarrhea

Adult check-in
2021-02-28
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-03-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-14
Survey response — day 21, dose 1
MedDRA: Ageusia, Drooling, Dry mouth, Dysgeusia, Fatigue, Memory impairment, Metabolic disorder, Parosmia — Feeling: Good

Free text: Get tired easily. Seem to be more forgetful. Sense of smell seems to have gotten worse, have a strange smell part of the time. Taste is still not back and I seem to have a metallic taste most of the time. Also alternate dry mouth and almost drooling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Dose 2 — Moderna
2021-03-21
Survey response — day 0, dose 2
MedDRA: Skin warm, Tinnitus — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Ears ringing, feel warm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia, Anosmia, COVID-19, Pain, Parosmia, Swelling — Feeling: Good · Site: Pain

Free text: Very mild pain, mainly when bumped or touched. Sense of smell has changed a bit. I had Covid in November and lost smell and taste. Was coming back very slowly (smell about A 1/3 and taste about 2/3, but this past week smell declined again in that a lot of things smell the same. Coffee and chlorine bleach have the same smell as an example and the smell isnt like either used to be. This could still be from the Covid, but I thought Id mention it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Issues described yesterday have not changed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — day 7, dose 2
MedDRA: Adverse reaction — Feeling: Good

Free text: Others are clearing and minor

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

Adult check-in
2021-04-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-25
Survey response — day 35, dose 2
MedDRA: Arthralgia, Feeling abnormal, Injection site pain — Feeling: Good

Free text: Arm is still sore at injection site. I have joint pains worse than before and still some fuzziness. Plus a couple other issues. But I think they are lingering from when I had Covid in late November. A few new issues seem to keep popping up. Shot ones

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-20
Survey response — 3 months, dose 2
MedDRA: Flatulence, Headache — Feeling: Fair

Free text: Headaches, intestinal gas,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-19
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Cough, Fatigue, Headache — Feeling: Fair

Free text: Intermittent cough, headache that has been hanging on for about a month, run down, aching joints.

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Dose 3 — Moderna
2022-03-21
Dose 4 — Moderna
2022-03-21
Survey response — 12 months, dose 2
MedDRA: Ageusia, Anosmia, Arthralgia, Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Taste and smell are off more More Joint pain Headaches

MedDRA releases: 2024-11 · check-in free text available
2022-06-20
Survey response — 3 months, dose 4
MedDRA: Asthenia, Cough, Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Intermittent Cough. Tired most of the time. No energy.

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Dry eye, Headache, Insomnia, Lower respiratory tract congestion, Nasal congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Nasal congestion. Bronchial congestion. Head aches. Dry eyes. Hard to sleep. Joint pains. Some I had before and the faded, but now are recurring

MedDRA releases: 2024-11 · check-in free text available
2023-03-21
Survey response — 12 months, dose 4
MedDRA: Fatigue, Headache, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-21
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-21	Moderna
2	2021-03-21	Moderna
3	2021-11-27	Moderna	No
4	2022-03-21	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-14

Symptoms: Get tired easily. Seem to be more forgetful. Sense of smell seems to have gotten worse, have a strange smell part of the time. Taste is still not back and I seem to have a metallic taste most of the time. Also alternate dry mouth and almost drooling cut off by CDC

Release 6 — day 0, dose 2

2021-03-21

Systemic reaction (other): Ears ringing, feel warm

Release 6 — days 1–6 daily, dose 2

2021-03-22

Systemic reaction (other): Dry eyes

2021-03-26

Systemic reaction (other): Very mild pain, mainly when bumped or touched. Sense of smell has changed a bit. I had Covid in November and lost smell and taste. Was coming back very slowly (smell about A 1/3 and taste about 2/3, but this past week smell declined again in that a lot of things smell the same. Coffee and chlorine bleach have the same smell as an example and the smell isnt like either used to be. This could still be from the Covid, but I thought Id mention it.

2021-03-27

Systemic reaction (other): Issues described yesterday have not changed.

Release 6 — day 7, dose 2

2021-03-28

Systemic reaction (other): Others are clearing and minor

Release 7 — day 35, dose 2

2021-04-25

Symptoms: Arm is still sore at injection site. I have joint pains worse than before and still some fuzziness. Plus a couple other issues. But I think they are lingering from when I had Covid in late November. A few new issues seem to keep popping up. Shot ones cut off by CDC

Release 9 — 3 months, dose 2

2021-06-20

Symptoms: Headaches, intestinal gas,

Release 9 — 6 months, dose 2

2021-09-19

Symptoms: Intermittent cough, headache that has been hanging on for about a month, run down, aching joints.

Release 11 — 12 months, dose 2

2022-03-21

Symptoms: Taste and smell are off more More Joint pain Headaches

Release 12 — 3 months, dose 4

2022-06-20

Symptoms: Intermittent Cough. Tired most of the time. No energy.

Release 12 — 6 months, dose 4

2022-09-19

Symptoms: Nasal congestion. Bronchial congestion. Head aches. Dry eyes. Hard to sleep. Joint pains. Some I had before and the faded, but now are recurring

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	Ageusia	✓	·	✓
SD	Anosmia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Drooling	✓	·	✓
SD	Dry eye	·	·	✓
SD	Dry mouth	✓	·	✓
SD	Dysgeusia	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Lower respiratory tract congestion	·	·	✓
SD	Memory impairment	✓	✓	✓
SD	Metabolic disorder	○	✓	○
SD	Nasal congestion	·	·	✓
SD	Parosmia	✓	✓	✓
SD	Tinnitus	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	COVID-19	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Skin warm	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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