ZWS-13418-71507

3 vaccinations 15 coded responses 38 check-ins 15 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 342 / FL
Registered: 2021-03-09

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

GTR-22185-91028 Adult relative or friend · Female · 2022-05-19

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Slight soreness at the injection site but not bad at all

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

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-11
Dose 2 — Moderna
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pain in left underarm, shot was in left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Slight pain under left arm pit area. Shot was given in left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear is worse then normal. I will see if it dissipates

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear still more than normal, not sure if vaccine is related but saw some side effects might include this

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear still worse then normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — day 14, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear is almost twice as bad as usual. It started after my second vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-09
Survey response — day 28, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear still persists, became worse after second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — day 35, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in ear still worse since 2nd dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Survey response — day 42, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear still much worse then before 2nd dose on April 11, 2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-11-19
Dose 3 — Moderna
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good · Site: Pain

Free text: Ringing in right ear from 2nd dose 4/11/21

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — day 7, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Ringing in right ear

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-19
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-11	Moderna
3	2021-11-19	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Slight soreness at the injection site but not bad at all

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Pain in left underarm, shot was in left arm

2021-04-14

Systemic reaction (other): Slight pain under left arm pit area. Shot was given in left arm

2021-04-16

Systemic reaction (other): Ringing in right ear is worse then normal. I will see if it dissipates

2021-04-17

Systemic reaction (other): Ringing in right ear still more than normal, not sure if vaccine is related but saw some side effects might include this

Release 7 — day 7, dose 2

2021-04-18

Systemic reaction (other): Ringing in right ear still worse then normal

Release 7 — day 14, dose 2

2021-04-25

Symptoms: Ringing in right ear is almost twice as bad as usual. It started after my second vaccine

Release 8 — day 28, dose 2

2021-05-09

Symptoms: Ringing in right ear still persists, became worse after second shot

Release 8 — day 35, dose 2

2021-05-17

Symptoms: Ringing in ear still worse since 2nd dose

Release 8 — day 42, dose 2

2021-05-23

Symptoms: Ringing in right ear still much worse then before 2nd dose on April 11, 2021

Release 10 — days 1–6 daily, dose 3

2021-11-21

Systemic reaction (other): Ringing in right ear from 2nd dose 4/11/21

2021-11-22

Systemic reaction (other): Ringing in right ear

2021-11-24

Systemic reaction (other): Ringing in right ear

2021-11-25

Systemic reaction (other): Ringing in right ear

Release 10 — day 7, dose 3

2021-11-26

Systemic reaction (other): Ringing in right ear

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	Tinnitus	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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