5B6-31943-36901
3 vaccinations
9 coded responses
34 check-ins
9 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 863 / AZ
- Registered
- 2021-02-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Registered in v-safe
-
2021-02-10
Dose 1 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Muscle or body achesFree text: Shoulder of shot onlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
- 2021-03-10
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Presyncope — Feeling: Fair · Site: Pain · Fever · Headache, Nausea, Abdominal painFree text: One Time felt I was going to faint, had to lay downMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-25
- 2021-04-02
- 2021-04-08
- 2021-04-14
-
2021-04-21
Survey response — day 42, dose 2MedDRA: Insomnia, Muscular weakness — Feeling: FairFree text: Weakness in legs & problems sleeping.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-09
Survey response — 3 months, dose 2MedDRA: Arthralgia, Fatigue — Feeling: FairFree text: Shoulder joint pain especially when stretching in the morning- both shoulders. More fatigue than normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-09-08
Survey response — 6 months, dose 2MedDRA: Arthralgia, Pain — Feeling: FairFree text: Intermittent pain in shoulders especially left extending to elbow mostly muscular. Started within a month of second shot and does not improve with time and occurs when moving to the back as when putting arm into the sleeve or stretching in the morninMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Dose 3 — Pfizer-BioNTech
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-03
- 2021-11-04
-
2021-11-11
Survey response — day 14, dose 3MedDRA: Eustachian tube disorder — Feeling: GoodFree text: Eustachian tube acting up.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-18
Survey response — day 21, dose 3MedDRA: Fatigue — Feeling: FairFree text: FatiguedMedDRA releases: 2024-11 · check-in free text available
- 2021-11-25
- 2021-12-02
- 2021-12-09
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Dysphagia, Office visit, Syncope — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Problems swallowing large pills. One fainting spell. · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-01-27
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)
- 2022-01-31
-
2022-02-01
Call successfulParticipant prefers to complete VAERS report online
-
2022-10-28
Survey response — 12 months, dose 3MedDRA: Pharyngeal disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Throat problemsMedDRA releases: 2024-11 · check-in free text available
-
2022-10-28
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-31
-
2022-10-31
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-28 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Shoulder of shot only
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): One Time felt I was going to faint, had to lay down
Release 7 — day 42, dose 2
Symptoms: Weakness in legs & problems sleeping.
Release 9 — 3 months, dose 2
Symptoms: Shoulder joint pain especially when stretching in the morning- both shoulders. More fatigue than normal.
Release 9 — 6 months, dose 2
Symptoms: Intermittent pain in shoulders especially left extending to elbow mostly muscular. Started within a month of second shot and does not improve with time and occurs when moving to the back as when putting arm into the sleeve or stretching in the mornin cut off by CDC
Release 10 — day 14, dose 3
Symptoms: Eustachian tube acting up.
Release 10 — day 21, dose 3
Symptoms: Fatigued
Release 11 — 3 months, dose 3
Symptoms: Problems swallowing large pills. One fainting spell.
Healthcare visit (other): Office visit
Release 12 — 12 months, dose 3
Symptoms: Throat problems
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Dysphagia | · | · | ✓ |
| SD | Eustachian tube disorder | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pharyngeal disorder | · | · | ✓ |
| SD | Syncope | · | · | ✓ |
| SRO | Presyncope | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release