ZW5-23984-83218

3 vaccinations 13 coded responses 40 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 900 / CA
Registered: 2021-01-09

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-08
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Site: Pain · Headache

Free text: Very mild headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Survey response — day 0, dose 2
MedDRA: Pruritus — Feeling: Good · Site: Pain · Headache

Free text: Since my first dose my chest has been itching a lot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Site: Pain · Headache

Free text: Itching on chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching all over my chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 21, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Wry itchy chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 28, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itch on chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Dose 3 — Moderna
2021-11-17
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Muscle or body aches

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Pruritus, Vaccine positive rechallenge — Feeling: Good

Free text: Lots of itching on chest. It happened with the 1 and 2 dose as well

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — day 7, dose 3
MedDRA: Pruritus — Feeling: Good

Free text: Lots of itching on chest

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-08
Survey response — day 21, dose 3
MedDRA: Arthralgia, Neck pain — Feeling: Good

Free text: Sore should and neck since shot

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-22
Survey response — day 35, dose 3
MedDRA: Arthralgia, Neck pain, Pruritus — Feeling: Good

Free text: Sore right shoulder/neck and itchy chest

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-16
Survey response — 3 months, dose 3
MedDRA: Brain fog, Pruritus — Feeling: Good

Free text: Brain fog, itch,

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — 6 months, dose 3
MedDRA: Blood potassium decreased, Diarrhoea, Dizziness, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headaches, diarrhea, low potassium, lightheadedness

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-19
Call 1 — Left Voicemail
2022-11-17
Survey response — 12 months, dose 3
MedDRA: Adverse reaction — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Developed symptoms after receiving my booster shot.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-11-17	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Very mild headache

Release 3 — day 0, dose 2

2021-02-05

Systemic reaction (other): Since my first dose my chest has been itching a lot

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Itching on chest

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): Itching all over my chest

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Wry itchy chest

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Itch on chest

Release 10 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): Lots of itching on chest. It happened with the 1 and 2 dose as well

Release 10 — day 7, dose 3

2021-11-24

Systemic reaction (other): Lots of itching on chest

Release 10 — day 21, dose 3

2021-12-08

Symptoms: Sore should and neck since shot

Release 10 — day 35, dose 3

2021-12-22

Symptoms: Sore right shoulder/neck and itchy chest

Release 11 — 3 months, dose 3

2022-02-16

Symptoms: Brain fog, itch,

Release 11 — 6 months, dose 3

2022-05-18

Symptoms: Headaches, diarrhea, low potassium, lightheadedness

Release 12 — 12 months, dose 3

2022-11-17

Symptoms: Developed symptoms after receiving my booster shot.

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	Adverse reaction	·	·	✓
SD	Arthralgia	·	·	✓
SD	Blood potassium decreased	·	·	✓
SD	Brain fog	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Headache	·	·	✓
SD	Neck pain	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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