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5EX-30180-58902

2 vaccinations 4 coded responses 21 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
61-65
ZIP prefix
236 / VA
Registered
2021-03-15
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-15
    Registered in v-safe
  2. 2021-03-15
    Dose 1 — Moderna
  3. 2021-03-15
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-03-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Back pain, Pain, Pain in extremity — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: I have a HIGH pain tolerance. With that context, my pain level rose to 8-9 laat night... especially back, legs, and arms. All deep bone hurt. Got up with lower ache level... today's high has been 5-7. With vaccines I tend toward a robust immune response so while higher level of pain than typical, nothing unexpected. Worth it!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  7. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  8. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-23
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-30
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-04-05
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-12
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-15
    Dose 2 — Moderna
  14. 2021-04-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Medical counselling, Sexual dysfunction — Feeling: Good · Site: Pain · Muscle or body aches · Get care from a doctor or other healthcare professional
    Free text: Systemic reaction (other): Have not been able to perform sexually on any day since injection. · Healthcare visit (other): Emailed PCM and will schedule appt should dysfunction continue.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-19
    Report sent to call center — days 1–6 daily, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-04-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Sleep disorder — Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Free text: Sleep disturbance.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-22
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-04-29
    Survey response — day 14, dose 2
    MedDRA: Back pain, High frequency ablation, Pain, Sexual dysfunction — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Getting MRI on L1 to L3. Intense pain and continued sexual disfunction. Had RFA one week after vaccination on L2 to L5. Yet now have severe acute pain below... even though RFA not known for this impact. Wondering what if any connection.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-05-06
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-15
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-21
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-27
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-10-17
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2022-02-26
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  26. 2022-04-17
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-15Moderna
22021-04-15Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): I have a HIGH pain tolerance. With that context, my pain level rose to 8-9 laat night... especially back, legs, and arms. All deep bone hurt. Got up with lower ache level... today's high has been 5-7. With vaccines I tend toward a robust immune response so while higher level of pain than typical, nothing unexpected. Worth it!

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Have not been able to perform sexually on any day since injection.
Healthcare visit (other): Emailed PCM and will schedule appt should dysfunction continue.

2021-04-20

Systemic reaction (other): Sleep disturbance.

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Getting MRI on L1 to L3. Intense pain and continued sexual disfunction. Had RFA one week after vaccination on L2 to L5. Yet now have severe acute pain below... even though RFA not known for this impact. Wondering what if any connection.

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDHigh frequency ablation ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDSexual dysfunction ✓ ✓ ✓
SROBack pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROSexual dysfunction ✓ ✓ ✓
SROSleep disorder ✓ ✓ ✓

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