ZWN-10078-57334

3 vaccinations 7 coded responses 26 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 939 / CA
Registered: 2021-03-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Ear discomfort, Nasal congestion, Paranasal sinus discomfort, Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sinus and ears pressure with slight congestion (stuffy)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Fair · Chills, Headache, Fatigue or tiredness, Diarrhea

Free text: Sinus Congestion and Runny Nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 7, dose 1
Feeling: Fair · None

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: None

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: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 35, dose 2
MedDRA: Ear infection, Eyelid infection, Headache, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Moderate upper and lower sinus infection, moderate lower left eyelid infection and moderate chronic headache and double ear infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-01
Dose 3 — Moderna
2022-04-04
Survey response — 12 months, dose 2
MedDRA: Headache, Respiratory tract congestion, Sinus congestion, Upper respiratory tract congestion — Feeling: Fair

Free text: Head/Sinus congestion, headache and slight upper respiratory congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Call successful
Not applicable - Accidental Reporting
2022-05-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-08-04
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Chest pain, Confusional state, Dyspnoea, Fatigue, Hyperhidrosis, Insomnia, Myalgia, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Long COVID effects: muscle aches, joint aches, short of breath, confusion, insomnia, fatigue, sweats and chest pains.

MedDRA releases: 2024-11 · check-in free text available
2023-02-03
Survey response — 12 months, dose 3
MedDRA: Angina pectoris, Dyspnoea, Neuropathy peripheral, Secretion discharge — Feeling: Fair · Be unable to do your normal daily activities, 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
2023-02-03
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · 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)
2023-02-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2022-02-01	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Sinus and ears pressure with slight congestion (stuffy)

2021-03-11

Systemic reaction (other): Sinus Congestion and Runny Nose

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): None

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Moderate upper and lower sinus infection, moderate lower left eyelid infection and moderate chronic headache and double ear infection.

Release 11 — 12 months, dose 2

2022-04-04

Symptoms: Head/Sinus congestion, headache and slight upper respiratory congestion.

Release 12 — 6 months, dose 3

2022-08-04

Symptoms: Long COVID effects: muscle aches, joint aches, short of breath, confusion, insomnia, fatigue, sweats and chest pains.

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	Angina pectoris	·	·	✓
SD	Arthralgia	·	·	✓
SD	Chest pain	·	·	✓
SD	Confusional state	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Ear infection	✓	✓	✓
SD	Eyelid infection	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	·	·	✓
SD	Insomnia	·	·	✓
SD	Myalgia	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Upper respiratory tract congestion	·	·	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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