3XR-31673-76886
5 vaccinations
7 coded responses
51 check-ins
7 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 028 / RI
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-15
Registered in v-safe
-
2021-02-15
Dose 1 — Moderna
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
-
2021-02-20
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesFree text: Upper right arm, injection was left armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-21
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Neck pain — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Pain in right side of neck and right shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-22
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesFree text: Right shoulder and neck. Injection was left arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
-
2021-03-08
Survey response — day 21, dose 1MedDRA: Arthralgia, Immunisation reaction, Neck pain, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pain in my right lower neck, right shoulder and right upper arm. Diagnosed on 3-5-21 as most likely bursitis. Treating with heat and topical anti-pain ointment. COVID Vaccination was in my left arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-15
Dose 2 — Moderna
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
-
2021-04-19
Survey response — day 35, dose 2MedDRA: Bursitis — Feeling: FairFree text: Bursitis in right shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Survey response — day 42, dose 2MedDRA: Bursitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Bursitis in right neck, right shoulder, and upper right arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-14
- 2021-09-13
-
2021-10-25
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
-
2021-12-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-06
-
2022-01-24
Survey response — 3 months, dose 3MedDRA: Pneumonia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Had pneumonia. Took antibiotics. All recovered now.MedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-12
Dose 4 — Moderna
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-07-12
-
2022-09-30
Dose 5 — ModernaCo-administered: Flu
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-12-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-09-30 | Moderna | Flu |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Upper right arm, injection was left arm
Systemic reaction (other): Pain in right side of neck and right shoulder
Release 4 — day 7, dose 1
Systemic reaction (other): Right shoulder and neck. Injection was left arm.
Release 5 — day 21, dose 1
Symptoms: Pain in my right lower neck, right shoulder and right upper arm. Diagnosed on 3-5-21 as most likely bursitis. Treating with heat and topical anti-pain ointment. COVID Vaccination was in my left arm.
Release 7 — day 35, dose 2
Symptoms: Bursitis in right shoulder
Release 8 — day 42, dose 2
Symptoms: Bursitis in right neck, right shoulder, and upper right arm.
Release 11 — 3 months, dose 3
Symptoms: Had pneumonia. Took antibiotics. All recovered now.
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 | Bursitis | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release