3AC-27943-84015

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 787 / TX
Registered: 2021-01-19

Relationship: Self
Race: White
Ethnicity: 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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-02-02
Survey response — day 14, dose 1
MedDRA: Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus — Feeling: Good

Free text: The injection site, which was only sore for a few days after the Tuesday, Jan 19 injection, became itchy on day 8 - Wednesday, January 27. I noticed the injection site had a yellow appearance, like an old bruise, surrounded by red where I scratched.

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

Adult check-in
2021-02-17
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 35, dose 1
MedDRA: Back pain, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lower back pain that is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Dose 2 — Moderna
2021-02-25
Survey response — day 0, dose 2
MedDRA: Back pain, Poor quality sleep — Feeling: Good · Site: Swelling · Muscle or body aches · Be unable to do your normal daily activities

Free text: Lower back pain since Sunday that is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Decreased appetite, Malaise, Poor quality sleep, Sensitivity to weather change — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches · Be unable to do your normal daily activities

Free text: Reduced appetite, but no nausea. Prior: Two hours after vaccination, felt 'disconnected', which lasted 1-2 hours. Also: Lower back pain since Sunday, which may be prolonged by vaccine aftereffects. The origin of the back pain is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Decreased appetite — Feeling: Fair · Site: Swelling · Muscle or body aches · Be unable to do your normal daily activities

Free text: Reduced appetite, but no nausea. Back pain existing prior to injection seems to be much reduced today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Injection site erythema, Injection site pallor, Injection site swelling, Pre-existing disease — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches

Free text: Noticed yesterday and today that in addition to general swelling around the injection site (which is gone today) there is a distinct bump where the actual injection took place. That bump was pale yesterday, but reddish today. Back pain existing prior to injection seems to be much reduced today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Injection site erythema, Injection site swelling — Feeling: Good · Site: Redness · Muscle or body aches

Free text: The bump at the precise injection site has reduced and is soft, and is the only spot with redness. Lower back ache has reduced, is lingering from before injection but is reported for completeness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pre-existing disease, Scar, Swelling — Feeling: Good · Site: Redness · Muscle or body aches

Free text: The former bump that isn't a bump anymore is a little red, more like a scar. Back pain existing prior to injection seems to be nearly gone today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Erythema, Swelling — Feeling: Good · Site: Redness · Muscle or body aches

Free text: The former bump that isn't a bump anymore is a little red, more like a scar. Back pain existing prior to injection now just a memory.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-03
Survey response — 12 months, dose 2
MedDRA: Fatigue, Headache, Pyrexia, Rhinorrhoea, Throat irritation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Scratchy throat, faint headache, slight fever, light fatigue, sniffles.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-25	Moderna

Free text

Release 3 — day 14, dose 1

2021-02-02

Symptoms: The injection site, which was only sore for a few days after the Tuesday, Jan 19 injection, became itchy on day 8 - Wednesday, January 27. I noticed the injection site had a yellow appearance, like an old bruise, surrounded by red where I scratched. cut off by CDC

Release 4 — day 35, dose 1

2021-02-24

Symptoms: Lower back pain that is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

Release 4 — day 0, dose 2

2021-02-25

Systemic reaction (other): Lower back pain since Sunday that is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Reduced appetite, but no nausea. Prior: Two hours after vaccination, felt 'disconnected', which lasted 1-2 hours. Also: Lower back pain since Sunday, which may be prolonged by vaccine aftereffects. The origin of the back pain is very likely the result of the significant energy conservation efforts brought about by Winter Storm Uri. Getting poor sleep on the floor while only heating the living room partially.

2021-02-28

Systemic reaction (other): Reduced appetite, but no nausea. Back pain existing prior to injection seems to be much reduced today.

2021-03-01

Systemic reaction (other): Noticed yesterday and today that in addition to general swelling around the injection site (which is gone today) there is a distinct bump where the actual injection took place. That bump was pale yesterday, but reddish today. Back pain existing prior to injection seems to be much reduced today.

2021-03-02

Systemic reaction (other): The bump at the precise injection site has reduced and is soft, and is the only spot with redness. Lower back ache has reduced, is lingering from before injection but is reported for completeness.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): The former bump that isn't a bump anymore is a little red, more like a scar. Back pain existing prior to injection seems to be nearly gone today.

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): The former bump that isn't a bump anymore is a little red, more like a scar. Back pain existing prior to injection now just a memory.

Release 11 — 12 months, dose 2

2022-03-03

Symptoms: Scratchy throat, faint headache, slight fever, light fatigue, sniffles.

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	Back pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Throat irritation	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pallor	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Scar	✓	✓	✓
SRO	Sensitivity to weather change	✓	✓	✓
SRO	Swelling	✓	✓	✓

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