244-27750-52266
3 vaccinations
8 coded responses
36 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 453 / OH
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
- 2021-02-04
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-06
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2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Shoulder injury related to vaccine administration, Vaccine positive rechallenge — Feeling: Good · Site: Pain · Muscle or body achesFree text: Have had left shoulder pain since first shot, aggravated by second. I think I may have developed "SIRVA" (shoulder injury related to vaccine administration)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Middle insomnia — Feeling: Fair · Site: Pain · Muscle or body achesFree text: Shoulder still quite sore. Wakes me up at night. ?SIRVA.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Muscle or body achesFree text: Shoulder still aches. ?"SIRVA" (shoulder injury related to vaccine administration)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — day 7, dose 2MedDRA: Arthralgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: Shoulder pain persistsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
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2021-03-24
Survey response — day 21, dose 2MedDRA: Arthralgia, Pain in extremity — Feeling: FairFree text: Increasing left shoulder and upper arm pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — day 28, dose 2MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Persistent left shoulder and upper arm painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Survey response — day 35, dose 2MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Persistent left shoulder painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Survey response — day 42, dose 2MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Persistent left upper arm and shoulder pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-02
- 2021-09-01
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2021-10-22
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
- 2022-04-22
- 2022-10-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Have had left shoulder pain since first shot, aggravated by second. I think I may have developed "SIRVA" (shoulder injury related to vaccine administration)
Systemic reaction (other): Shoulder still quite sore. Wakes me up at night. ?SIRVA.
Systemic reaction (other): Shoulder still aches. ?"SIRVA" (shoulder injury related to vaccine administration)
Release 5 — day 7, dose 2
Systemic reaction (other): Shoulder pain persists
Release 6 — day 21, dose 2
Symptoms: Increasing left shoulder and upper arm pain.
Release 6 — day 28, dose 2
Symptoms: Persistent left shoulder and upper arm pain
Release 7 — day 35, dose 2
Symptoms: Persistent left shoulder pain
Release 7 — day 42, dose 2
Symptoms: Persistent left upper arm and shoulder pain.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
| SRO | Shoulder injury related to vaccine administration | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release