3JA-12928-11731

2 vaccinations 10 coded responses 23 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 957 / CA
Registered: 2021-01-28

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

2021-01-25
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Fatigue or tiredness

Free text: Chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Dose 2 — Moderna
2021-02-22
Survey response — day 0, dose 2
MedDRA: Ear discomfort — Feeling: Good · Site: Redness

Free text: My ears felt a little sunburned, but havent been in the sun.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Very sore arm. It feel like someone hit it with a brick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Oral herpes — Feeling: Good

Free text: Cold sore

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: Oral herpes — Feeling: Good

Free text: Cold sore

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: Oral herpes — Feeling: Good · Joint pains

Free text: Cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 7, dose 2
MedDRA: Oral herpes — Feeling: Good · Joint pains

Free text: Cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 21, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Not really worse, but continuing arthritic type pain in right knee that started the day after the injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 28, dose 2
MedDRA: Arthralgia, Arthritis, Joint stiffness, Musculoskeletal stiffness, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Arthritic symptom in my right knee is getting worse. Joint pain and stiffness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — day 35, dose 2
MedDRA: Arthralgia, Self-medication — Feeling: Good · Be unable to do your normal daily activities

Free text: Knee pain has worsened. It started with the pain in other joints the day after the 2nd vaccination, but unlike in other joints this has gotten worse. Im taking a regimen of ibuprofen to see if subsides.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-24
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-22	Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Chest discomfort

Release 4 — day 0, dose 2

2021-02-22

Systemic reaction (other): My ears felt a little sunburned, but havent been in the sun.

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Very sore arm. It feel like someone hit it with a brick.

2021-02-26

Systemic reaction (other): Cold sore

2021-02-27

Systemic reaction (other): Cold sore

2021-02-28

Systemic reaction (other): Cold sore

Release 4 — day 7, dose 2

2021-03-01

Systemic reaction (other): Cold sore

Release 5 — day 21, dose 2

2021-03-15

Symptoms: Not really worse, but continuing arthritic type pain in right knee that started the day after the injection.

Release 6 — day 28, dose 2

2021-03-22

Symptoms: Arthritic symptom in my right knee is getting worse. Joint pain and stiffness.

Release 6 — day 35, dose 2

2021-03-29

Symptoms: Knee pain has worsened. It started with the pain in other joints the day after the 2nd vaccination, but unlike in other joints this has gotten worse. Im taking a regimen of ibuprofen to see if subsides.

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	Arthritis	✓	✓	✓
SD	Joint stiffness	✓	·	✓
SD	Musculoskeletal stiffness	○	✓	○
SD	Pre-existing disease	✓	·	✓
SD	Self-medication	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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