5B6-21172-45655

4 vaccinations 9 coded responses 37 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 430 / OH
Registered: 2021-03-11

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-09
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Renal pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Kidney area pain in back on both sides but more severe on right side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Back pain in left side kidney area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-06
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pain in left arm that has been intensifying and waiting fir approval to see a doctor/specialist for this.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-06
Dose 3 — Moderna
2022-04-06
Survey response — 12 months, dose 2
MedDRA: Arthritis, Nervous system disorder, Office visit, Precancerous lesion excision — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nerve and arthritis issues as well as a pre-cancerous mole removed from my chest. · Healthcare visit (other): Office visits

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-11
Call 1 — Left Voicemail
2022-05-06
Dose 4 — Pfizer-BioNTech
2022-05-06
Health check-in — day 0, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-10
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Constipation.not sure if it's attributed to vaccine or not?

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-13
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-20
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-27
Survey response — day 21, dose 4
MedDRA: Pain in extremity — Feeling: Fair

Free text: Arm soreness

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Survey response — day 28, dose 4
MedDRA: Pain in extremity — Feeling: Fair · Be unable to work or attend school

Free text: Soreness in arm from shot.

MedDRA releases: 2024-11 · check-in free text available
2022-06-10
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-17
Survey response — day 42, dose 4
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Soreness in arm

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-12-06	Moderna	No
4	2022-05-06	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Kidney area pain in back on both sides but more severe on right side.

2021-03-12

Systemic reaction (other): Back pain in left side kidney area

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Weakness

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Pain in left arm that has been intensifying and waiting fir approval to see a doctor/specialist for this.

Release 11 — 12 months, dose 2

2022-04-06

Symptoms: Nerve and arthritis issues as well as a pre-cancerous mole removed from my chest.

Healthcare visit (other): Office visits

Release 11 — days 1–6 daily, dose 4

2022-05-10

Systemic reaction (other): Constipation.not sure if it's attributed to vaccine or not?

Release 11 — day 21, dose 4

2022-05-27

Symptoms: Arm soreness

Release 11 — day 28, dose 4

2022-06-03

Symptoms: Soreness in arm from shot.

Release 12 — day 42, dose 4

2022-06-17

Symptoms: Soreness in arm

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
HCVO	Office visit	·	·	✓
SD	Arthritis	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Precancerous lesion excision	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Constipation	·	·	✓
SRO	Renal pain	✓	✓	✓

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