ZWJ-44132-79675

4 vaccinations 12 coded responses 51 check-ins 11 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 222 / VA
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Arm is tender in Vic of the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Flatulence — Feeling: Good

Free text: Gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 14, dose 1
MedDRA: Constipation — Feeling: Good

Free text: Constipation, 1-1/2 days ending yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 21, dose 1
MedDRA: Diverticulitis, Pre-existing disease — Feeling: Good

Free text: Diverticulitis flared up on Sun and Mon, most severe in about two years, I considered seeing a doctor however decided not to. Condition returned to normal after snot 36 hrs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Toothache — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Toothache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Sleep disorder — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Since receiving shot #2, most nights for reasons I dont understand, I wake up at between 3:00 and 4:30. It takes me 60 to 90 min to fall back asleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 7, dose 2
MedDRA: Middle insomnia, Sleep disorder — Feeling: Good · Site: Itching

Free text: Continue to have sleep interrupted, waking at between 3:30 and 4:30 for no obvious reason,

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

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

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

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

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

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

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-14
Dose 4 — Moderna
2022-04-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-17
Survey response — days 1–6 daily, dose 4
MedDRA: Abnormal faeces, Bowel movement irregularity — Feeling: Good · Site: Pain

Free text: Difficult bowel movement and very hard feces.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-19
Survey response — days 1–6 daily, dose 4
MedDRA: Discomfort, Flatulence, Sleep disorder — Feeling: Fair · Fatigue or tiredness

Free text: Gas. Sleep last night was intermittently interrupted by gas and abdominal pressure on bladder.

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-21
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-30
Survey response — day 14, dose 4
MedDRA: Dizziness, Feeling hot — Feeling: Good

Free text: Intermittent dizziness, for two days early last week. This was sometimes accompanied by an intermittent sensation of low fever.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-14
Survey response — 3 months, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Probably unrelated: worsening of existing back and shoulder pain issues.

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-14
Survey response — 12 months, dose 4
MedDRA: Hernia — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-11-05	Moderna	No
4	2022-04-14	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Arm is tender in Vic of the injection site.

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): Gas

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Constipation, 1-1/2 days ending yesterday.

Release 6 — day 21, dose 1

2021-03-24

Symptoms: Diverticulitis flared up on Sun and Mon, most severe in about two years, I considered seeing a doctor however decided not to. Condition returned to normal after snot 36 hrs.

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Toothache

2021-04-04

Systemic reaction (other): Since receiving shot #2, most nights for reasons I dont understand, I wake up at between 3:00 and 4:30. It takes me 60 to 90 min to fall back asleep.

Release 7 — day 7, dose 2

2021-04-07

Systemic reaction (other): Continue to have sleep interrupted, waking at between 3:30 and 4:30 for no obvious reason,

Release 11 — days 1–6 daily, dose 4

2022-04-17

Systemic reaction (other): Difficult bowel movement and very hard feces.

2022-04-19

Systemic reaction (other): Gas. Sleep last night was intermittently interrupted by gas and abdominal pressure on bladder.

Release 11 — day 14, dose 4

2022-04-30

Symptoms: Intermittent dizziness, for two days early last week. This was sometimes accompanied by an intermittent sensation of low fever.

Release 12 — 3 months, dose 4

2022-07-14

Symptoms: Probably unrelated: worsening of existing back and shoulder pain issues.

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	Condition aggravated	·	·	✓
SD	Constipation	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Feeling hot	·	·	✓
SD	Hernia	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Abnormal faeces	·	·	✓
SRO	Bowel movement irregularity	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Flatulence	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Toothache	✓	✓	✓

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