38L-25392-30419

4 vaccinations 4 coded responses 24 check-ins 4 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 482 / MI
Registered: 2021-02-02

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2455994 (opens in a new window)	high	10 / 11	—	1 of 3 VAERS symptoms	same dose (4)	MI matches	2022-08-20 / 2022-08-21 / 2022-09-23 received 11 days before the last call	case 1058643

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Good

Free text: Very Very slight stiffness at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Joint pains, Muscle or body aches

Free text: Yes after receiving my first shot I started noticing joint pain in my left arm I didn't think a whole lot about it since it was my left arm and I received my shot in the right arm I exercise regularly and did not have any kind of pain until after the vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-16
Dose 3 — Moderna
2022-08-20
Dose 4 — Moderna
2022-09-22
Survey response — day 28, dose 4
MedDRA: Injection site pain, Office visit, Rotator cuff syndrome — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I received my 2nd booster 8-20-22 after receiving it I had severe pain at injection site this has persisted since 8-20 I went to my doctor and they told me I had a tear in my rotator cuff I had no noticeable pain prior the vaccine I did not have any

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-23
Call 1 — Left Voicemail
2022-09-23
Call successful
Completed over the phone
2022-10-03
Survey response — day 42, dose 4
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pain in my right shoulder since 8-20

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-04
Call successful
Reported to VAERS during previous contact from GDIT

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-03	Moderna
3	2021-11-16	Moderna	No
4	2022-08-20	Moderna	No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Very Very slight stiffness at injection site

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): Yes after receiving my first shot I started noticing joint pain in my left arm I didn't think a whole lot about it since it was my left arm and I received my shot in the right arm I exercise regularly and did not have any kind of pain until after the vaccination

Release 12 — day 28, dose 4

2022-09-22

Symptoms: I received my 2nd booster 8-20-22 after receiving it I had severe pain at injection site this has persisted since 8-20 I went to my doctor and they told me I had a tear in my rotator cuff I had no noticeable pain prior the vaccine I did not have any cut off by CDC

Release 12 — day 42, dose 4

2022-10-03

Symptoms: Pain in my right shoulder since 8-20

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	Office visit	·	·	✓
SD	Rotator cuff syndrome	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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