3PP-10367-99708
2 vaccinations
5 coded responses
27 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 911 / CA
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-24
Registered in v-safe
-
2021-03-24
Dose 1 — Moderna
- 2021-03-24
-
2021-03-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-26
- 2021-03-27
-
2021-03-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Muscle or body achesAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
-
2021-04-23
Dose 2 — Moderna
-
2021-04-23
Survey response — day 0, dose 2MedDRA: Musculoskeletal stiffness — Feeling: Fair · Site: SwellingFree text: My arm is a little bit stiffMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Abdominal CrampsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-04-28
- 2021-04-29
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
-
2021-07-23
Survey response — 3 months, dose 2MedDRA: Blood cholesterol increased, Dysstasia, Pain in extremity, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: High cholesterol. Swelling of the feet and sometimes hands if sitting for too long. Difficulty standing for prolonged period of time due to pain in feet.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-23
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-02
Call successfulParticipant prefers to complete VAERS report online
-
2021-10-24
Survey response — 6 months, dose 2MedDRA: Blood cholesterol increased, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I have swollen feet and sometimes hands if I sit for more than an hour. I had high cholesterol which I've never had and had to take medication to bring it down.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-24
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-10-26
-
2021-10-29
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-23
Survey response — 12 months, dose 2MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Back pain. I don't think it is related to the vaccination.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-25
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-24 | Moderna | |
| 2 | 2021-04-23 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): My arm is a little bit stiff
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Abdominal Cramps
Release 9 — 3 months, dose 2
Symptoms: High cholesterol. Swelling of the feet and sometimes hands if sitting for too long. Difficulty standing for prolonged period of time due to pain in feet.
Release 10 — 6 months, dose 2
Symptoms: I have swollen feet and sometimes hands if I sit for more than an hour. I had high cholesterol which I've never had and had to take medication to bring it down.
Release 11 — 12 months, dose 2
Symptoms: Back pain. I don't think it is related to the vaccination.
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 | Blood cholesterol increased | ✓ | · | ✓ |
| SD | Dysstasia | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SD | Peripheral swelling | ✓ | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release