5ZZ-78587-30788
1 vaccination
3 coded responses
11 check-ins
3 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 211 / MD
- Registered
- 2021-03-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Dose 1 — Moderna
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2021-03-14
Registered in v-safe
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2021-03-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Injection site reaction, Muscle swelling, Office visit — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Yesterday I was seen by an Orthopedist for pain & swelling at my RIGHT deltoid muscle (site of vaccine injection) and shoulder.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Injection site swelling, Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): I sometimes get stress-triggered migraines & have been feeling pain and swelling in my Right shoulder and Upper arm (near the site of the injection). · Healthcare visit (other): Being seen by an OrthopedistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-19
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-26
Survey response — day 14, dose 1MedDRA: Arthralgia, Fatigue, Headache, Joint stiffness, Muscle tightness, Pain in extremity, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Some severe headache issues, exceptional fatigue and soreness & tightness in my Right arm and shoulder. · Healthcare visit (other): Outpatient Physical TherapyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-03
- 2021-06-11
- 2021-09-13
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2022-03-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 5 — days 1–6 daily, dose 1
Healthcare visit (other): Yesterday I was seen by an Orthopedist for pain & swelling at my RIGHT deltoid muscle (site of vaccine injection) and shoulder.
Systemic reaction (other): I sometimes get stress-triggered migraines & have been feeling pain and swelling in my Right shoulder and Upper arm (near the site of the injection).
Healthcare visit (other): Being seen by an Orthopedist
Release 6 — day 14, dose 1
Symptoms: Some severe headache issues, exceptional fatigue and soreness & tightness in my Right arm and shoulder.
Healthcare visit (other): Outpatient Physical Therapy
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 | Injection site pain | ✓ | ✓ | ✓ |
| HCVO | Injection site reaction | ✓ | ✓ | ✓ |
| HCVO | Muscle swelling | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Physiotherapy | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| HCVO | Vaccination site swelling | ○ | ○ | ○ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Muscle tightness | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release