ZYQ-84950-47641

3 vaccinations 7 coded responses 28 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 26-30
ZIP prefix: 782 / TX
Registered: 2020-12-28

Relationship: Self
Race: White
Ethnicity: 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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · Chills, Headache

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Myalgia, Pre-existing disease — Feeling: Good · Muscle or body aches

Free text: Not sure if exercise induced, left trapezius hurts consistently. No other body aches. PMH: HTN stage 2, OSA, ADD,

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

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

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Nausea

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Back pain, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Dose 2 — Moderna
2021-01-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Conjunctivitis, Dyspnoea, Flatulence, Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I have a sore throat, excessive flatulence, conjunctivitis, shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Survey response — day 14, dose 2
MedDRA: Exposure to SARS-CoV-2, Headache, Oropharyngeal pain — Feeling: Good

Free text: Had exposure to covid patient on 2/6 and I developed headache and sore throat that resolved 48 hours later.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headache new onset.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Survey response — 6 months, dose 2
MedDRA: Brain fog, Headache — Feeling: Good

Free text: Headaches and memory fogginess

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-26
Dose 3 — Pfizer-BioNTech
2021-11-27
Survey response — days 1–6 daily, dose 3
MedDRA: Dyspnoea, Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school

Free text: Shortness of breath, palpiatations

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-12-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-25	Moderna
3	2021-11-26	Pfizer-BioNTech	No

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Not sure if exercise induced, left trapezius hurts consistently. No other body aches. PMH: HTN stage 2, OSA, ADD,

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Sore throat, back pain.

Release 2 — days 1–6 daily, dose 2

2021-01-26

Systemic reaction (other): I have a sore throat, excessive flatulence, conjunctivitis, shortness of breath.

Release 3 — day 14, dose 2

2021-02-08

Symptoms: Had exposure to covid patient on 2/6 and I developed headache and sore throat that resolved 48 hours later.

Release 5 — day 35, dose 2

2021-03-03

Symptoms: Headache new onset.

Release 9 — 6 months, dose 2

2021-07-28

Symptoms: Headaches and memory fogginess

Release 10 — days 1–6 daily, dose 3

2021-11-27

Systemic reaction (other): Shortness of breath, palpiatations

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	Back pain	✓	✓	✓
SD	Brain fog	✓	·	✓
SD	Exposure to SARS-CoV-2	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SRO	Conjunctivitis	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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