2LY-87639-24760

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 773 / TX
Registered: 2021-01-11

Relationship: Self
Race: White
Ethnicity: Not 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

2021-01-11
Registered in v-safe
2021-01-11
Dose 1 — Moderna
2021-01-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Mild Bicep muscle pain on injection arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — day 14, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Continuing mild pain at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-08
Survey response — day 28, dose 1
MedDRA: Injection site pain, Muscle tightness — Feeling: Good

Free text: Mild to moderate pain at injection site. Bicep muscle tightness. Condition not improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Dose 2 — Moderna
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 28, dose 2
MedDRA: Injection site pain, Musculoskeletal stiffness — Feeling: Good

Free text: Not new or worsening, but still have light pain at injection site in arm and slight stiffness in hand from the initial (first) injection on January 11, 2021.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 35, dose 2
MedDRA: Injection site pain, Pain in extremity — Feeling: Good

Free text: Not new or worsening. Mild Pain at original injection site, arm and hand lreceived January 11th continues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 42, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: No new or worsening pain. Still have slight pain at injection site from first COVID vaccination received January 11 th.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Injection site pain, Pain in extremity — Feeling: Good

Free text: Same issue as in past. After first vaccination on January 11, 2021 developed soreness at injection site and then mild pain in RH arm. Mild pain (sometimes increasing) at injection site. Heavy use of right arm causes pain to increase.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-14
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Injection site pain, Myalgia — Feeling: Good

Free text: Symptom not new. After receiving first vaccination, Jan 11, in right arm soreness and light pain occurred at site and in bicep. At present when exercising arm slight pain occurs in bicep and shoulder joint.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-10	Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Mild Bicep muscle pain on injection arm

Release 2 — day 14, dose 1

2021-01-25

Symptoms: Continuing mild pain at injection site.

Release 3 — day 28, dose 1

2021-02-08

Symptoms: Mild to moderate pain at injection site. Bicep muscle tightness. Condition not improving.

Release 5 — day 28, dose 2

2021-03-10

Symptoms: Not new or worsening, but still have light pain at injection site in arm and slight stiffness in hand from the initial (first) injection on January 11, 2021.

Release 5 — day 35, dose 2

2021-03-19

Symptoms: Not new or worsening. Mild Pain at original injection site, arm and hand lreceived January 11th continues.

Release 6 — day 42, dose 2

2021-03-25

Symptoms: No new or worsening pain. Still have slight pain at injection site from first COVID vaccination received January 11 th.

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Same issue as in past. After first vaccination on January 11, 2021 developed soreness at injection site and then mild pain in RH arm. Mild pain (sometimes increasing) at injection site. Heavy use of right arm causes pain to increase.

Release 9 — 6 months, dose 2

2021-08-14

Symptoms: Symptom not new. After receiving first vaccination, Jan 11, in right arm soreness and light pain occurred at site and in bicep. At present when exercising arm slight pain occurs in bicep and shoulder joint.

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	Injection site pain	✓	✓	✓
SD	Muscle tightness	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Myalgia	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SRO	Injection site pain	✓	✓	✓

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