3ZF-31041-43681

2 vaccinations 8 coded responses 20 check-ins 8 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 775 / TX
Registered: 2021-01-30

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Free text: No

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Site: Pain, Itching

Free text: Lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-15
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Right side of neck was hurting And headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 21, dose 1
MedDRA: Vision blurred — Feeling: Good

Free text: Short Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-15
Survey response — day 14, dose 2
MedDRA: Back pain, Feeling of body temperature change, Headache, Rhinorrhoea — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Running noses Pain in lower backHod and cold spells Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 28, dose 2
MedDRA: Arthralgia, Neck pain, Pain in extremity — Feeling: Fair

Free text: Shoulder , arm and neck painNot sure if its related to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Headache, Muscle spasms — Feeling: Poor · Be unable to work or attend school

Free text: Champs in the hand Muscle spasm alongside my back also Headache

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-16
Call 1 — Left Voicemail
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Back pain, Headache, Mass, Neck pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: I have started getting back pains neck pains also got a lump on my right show the area it what else have our receive after the vaccine headaches that's it

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-03-01	Moderna

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-01-30

Systemic reaction (other): No

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): Lower back pain

Release 4 — day 14, dose 1

2021-02-15

Symptoms: Right side of neck was hurting And headaches

Release 4 — day 21, dose 1

2021-02-20

Symptoms: Short Blurry vision

Release 5 — day 14, dose 2

2021-03-15

Symptoms: Running noses Pain in lower backHod and cold spells Headache

Release 6 — day 28, dose 2

2021-03-31

Symptoms: Shoulder , arm and neck painNot sure if its related to vaccination

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Champs in the hand Muscle spasm alongside my back also Headache

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: I have started getting back pains neck pains also got a lump on my right show the area it what else have our receive after the vaccine headaches that's it

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	Back pain	✓	✓	✓
SD	Feeling of body temperature change	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Mass	·	·	✓
SD	Muscle spasms	✓	·	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Unevaluable event	·	·	✓
SD	Vision blurred	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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