3E9-17176-25976

3 vaccinations 6 coded responses 25 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 770 / TX
Registered: 2021-01-15

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Muscle or body aches

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Muscle or body aches

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Joint range of motion decreased, Musculoskeletal stiffness, Pain in extremity — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: The sore arm of prior days moved to a very stiff neck, likely the trapezius muscles.I treated with ice on and off last night. Range of ability to turn my beck is limited. Pain is annoying but not acute. Symptoms continue today. I maintain myself in good physical condition and have never had a stiff neck in the past. There was no incident other than the vaccine injection that this stiffness can be attributed to.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain — Feeling: Good · Muscle or body aches

Free text: I described this yesterday. The sore neck muscles are nearly gone. No arm soreness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Influenza like illness, Pain in extremity — Feeling: Good

Free text: I received 2nd vaccine on 2/20. I had mild flu like symptoms and a very sore arm on 2/21 and 2/22

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-27
Dose 3 — Moderna
2021-10-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-27
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid 19 in late April and early May

MedDRA releases: 2024-11 · check-in free text available
2022-09-27
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-29
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-20	Moderna
3	2021-09-27	Moderna	No

Call center

2 call center cases

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

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): None

2021-01-17

Systemic reaction (other): None

2021-01-18

Systemic reaction (other): The sore arm of prior days moved to a very stiff neck, likely the trapezius muscles.I treated with ice on and off last night. Range of ability to turn my beck is limited. Pain is annoying but not acute. Symptoms continue today. I maintain myself in good physical condition and have never had a stiff neck in the past. There was no incident other than the vaccine injection that this stiffness can be attributed to.

2021-01-19

Systemic reaction (other): I described this yesterday. The sore neck muscles are nearly gone. No arm soreness

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): I received 2nd vaccine on 2/20. I had mild flu like symptoms and a very sore arm on 2/21 and 2/22

Release 12 — 12 months, dose 3

2022-09-27

Symptoms: Covid 19 in late April and early May

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	COVID-19	·	·	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Joint range of motion decreased	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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