332-17284-14191
3 vaccinations
5 coded responses
35 check-ins
5 free-text entries
5 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 080 / NJ
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
- 2021-03-04
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
- 2021-09-30
-
2021-10-25
Dose 3 — Moderna
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
-
2021-10-30
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-01
-
2021-11-04
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Pain in extremity — Feeling: FairFree text: Still extreme pain in the arm I got the booster shot in.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Injection site pain, Medical counselling — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: Too much pain at site of injection Pain is unbearable at times · Healthcare visit (other): Phone call to primary, talked to am orthopedic since I had an appointment, talked to pharmacist who gives these injectionsMedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-16
-
2021-11-22
Survey response — day 28, dose 3MedDRA: Injection site pain, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in the injection site, 5 weeks today · Healthcare visit (other): Primary visit todayMedDRA releases: 2024-11 · check-in free text available
-
2021-11-22
Report sent to call center — day 28, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-11-23
Call successfulReported to VAERS voluntarily prior to GDIT contact
-
2021-11-30
Survey response — day 35, dose 3MedDRA: Office visit, Pain in extremity — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: Still pain in left arm Getting a ultra sound and a nerve conduction test This is ridiculous · Healthcare visit (other): In officeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-30
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-06
Survey response — day 42, dose 3MedDRA: Injection site pain, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Same pain in left upper arm where I got the booster · Healthcare visit (other): Ultra sound tomorrowMedDRA releases: 2024-11 · check-in free text available
-
2021-12-06
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-13
Call successfulReported to VAERS during previous contact from GDIT
- 2022-01-26
- 2022-04-25
- 2022-10-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
5 call center cases
5 successful
VAERS report filed, before or during a call: 4
Free text
Release 10 — day 14, dose 3
Symptoms: Still extreme pain in the arm I got the booster shot in.
Release 10 — day 21, dose 3
Symptoms: Too much pain at site of injection Pain is unbearable at times
Healthcare visit (other): Phone call to primary, talked to am orthopedic since I had an appointment, talked to pharmacist who gives these injections
Release 10 — day 28, dose 3
Symptoms: Pain in the injection site, 5 weeks today
Healthcare visit (other): Primary visit today
Release 10 — day 35, dose 3
Symptoms: Still pain in left arm Getting a ultra sound and a nerve conduction test This is ridiculous
Healthcare visit (other): In office
Release 10 — day 42, dose 3
Symptoms: Same pain in left upper arm where I got the booster
Healthcare visit (other): Ultra sound tomorrow
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 |
|---|---|---|---|---|
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release