2CK-23921-73626

2 vaccinations 9 coded responses 21 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 165 / PA
Registered: 2020-12-21

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

Timeline

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

2020-12-21
Registered in v-safe
2020-12-21
Dose 1 — Moderna
2020-12-21
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2020-12-22
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Pain in left arm from shoulder to elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Redness, Swelling, Itching · Headache

Free text: These started yesterday afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site inflammation, Injection site pruritus — Feeling: Good

Free text: Not sure if this was on my last thing or not. But has severe redness and itchiness around the injection site for about 2 days. Raised area of inflammation about the size of 2 half dollars. Since resolved. Now seem fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-18
Dose 2 — Moderna
2021-01-18
Survey response — day 0, dose 2
MedDRA: Dizziness, Vision blurred — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Blurry vision, light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — day 0, dose 2
Be unable to work

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-20
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Hyperhidrosis, Pyrexia — Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Did not have a fever anytime I tested but felt feverish, hot, sweaty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache

Free text: No fever, but have felt feverish.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Hyperhidrosis — Feeling: Fair · Site: Redness · Fever · Chills

Free text: Hot, sweaty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Headache

Adult check-in
2021-02-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-10
Survey response — day 21, dose 2
MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good

Free text: More redness and itchiness at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-20
Survey response — 12 months, dose 2
MedDRA: Chest pain, Chills, Dyspnoea, Emergency care, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Booster almost 2 weeks ago. Had chills and fever for 2 days. But since have had shortness of breath and chest pains. Went to ER 48 hours after getting vaccine for that reason was told most likely just side affect of vaccine. Not a complication of

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-01-21
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-21	Moderna
2	2021-01-18	Moderna

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-22

Systemic reaction (other): Pain in left arm from shoulder to elbow

Release 1 — day 7, dose 1

2020-12-30

Systemic reaction (other): These started yesterday afternoon.

Release 1 — day 14, dose 1

2021-01-05

Symptoms: Not sure if this was on my last thing or not. But has severe redness and itchiness around the injection site for about 2 days. Raised area of inflammation about the size of 2 half dollars. Since resolved. Now seem fine.

Release 2 — day 0, dose 2

2021-01-18

Systemic reaction (other): Blurry vision, light headed

Release 2 — days 1–6 daily, dose 2

2021-01-20

Systemic reaction (other): Did not have a fever anytime I tested but felt feverish, hot, sweaty

2021-01-21

Systemic reaction (other): No fever, but have felt feverish.

2021-01-22

Systemic reaction (other): Hot, sweaty

Release 4 — day 21, dose 2

2021-02-10

Symptoms: More redness and itchiness at injection site

Release 10 — 12 months, dose 2

2022-01-20

Symptoms: Booster almost 2 weeks ago. Had chills and fever for 2 days. But since have had shortness of breath and chest pains. Went to ER 48 hours after getting vaccine for that reason was told most likely just side affect of vaccine. Not a complication of

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	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Unevaluable event	○	○	○
SRO	Vision blurred	✓	✓	✓

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