ZW9-47384-75932

4 vaccinations 10 coded responses 29 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 36-40
ZIP prefix: 209 / MD
Registered: 2021-01-30

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

2021-01-06
Dose 1 — Moderna
2021-01-30
Registered in v-safe
2021-01-30
Dose 2 — Moderna
2021-01-30
Survey response — day 0, dose 2
MedDRA: Dissociation, Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Tiny bit of dizziness/disconnected feeling.

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: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Fatigue — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slight chest tightness when very fatigued this afternoon. Severe fatigue only lasted about 3 hours and better after nap.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Some slightly runny stool, but wouldnt call it diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-01
Survey response — 3 months, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Severe to moderate cramping in back/shoulder blade area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-02
Dose 3 — Moderna
2022-02-01
Survey response — 12 months, dose 2
MedDRA: Diarrhoea, Headache, Oropharyngeal pain, SARS-CoV-2 test negative, Upper-airway cough syndrome — Feeling: Good

Free text: Sore throat, diarrhea, headache, post-nasal drip, lasting one day. PCR test 2 days before symptoms, during symptoms, and 2 days after symptoms all came back negative for covid.

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Dose 4 — Moderna
Co-administered: Flu
2022-10-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-10-21
Survey response — days 1–6 daily, dose 4
MedDRA: Angina pectoris, Myalgia — Feeling: Good · Site: Pain · Nausea, Diarrhea

Free text: Chest pain around heart or left pectoral musclemild to moderate coming and going.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Survey response — days 1–6 daily, dose 4
MedDRA: Angina pectoris, Myalgia — Feeling: Good · Site: Pain

Free text: Slight intermittent pain around my heart or left pectoral muscle.

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-25
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-03
Survey response — day 14, dose 4
MedDRA: Cough, Rhinorrhoea — Feeling: Fair

Free text: Runny nose and cough.

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-17
Survey response — day 28, dose 4
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Runny nose, cough, sore throat.

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-17
Survey response — 3 months, dose 4
MedDRA: Cough, Upper-airway cough syndrome — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11
2023-04-18
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-01-30	Moderna
3	2021-11-02	Moderna	No
4	2022-10-18	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — day 0, dose 2

2021-01-30

Systemic reaction (other): Tiny bit of dizziness/disconnected feeling.

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Slight chest tightness when very fatigued this afternoon. Severe fatigue only lasted about 3 hours and better after nap.

2021-02-04

Systemic reaction (other): Some slightly runny stool, but wouldnt call it diarrhea

Release 8 — 3 months, dose 2

2021-05-01

Symptoms: Severe to moderate cramping in back/shoulder blade area.

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Sore throat, diarrhea, headache, post-nasal drip, lasting one day. PCR test 2 days before symptoms, during symptoms, and 2 days after symptoms all came back negative for covid.

Release 12 — days 1–6 daily, dose 4

2022-10-21

Systemic reaction (other): Chest pain around heart or left pectoral musclemild to moderate coming and going.

2022-10-22

Systemic reaction (other): Slight intermittent pain around my heart or left pectoral muscle.

Release 12 — day 14, dose 4

2022-11-03

Symptoms: Runny nose and cough.

Release 12 — day 28, dose 4

2022-11-17

Symptoms: Runny nose, cough, sore throat.

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	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Angina pectoris	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dissociation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Myalgia	·	·	✓

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