666-17044-21948

3 vaccinations 7 coded responses 39 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 31-35
ZIP prefix: 945 / CA
Registered: 2021-03-20

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased, Pain in extremity — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Pain in upper left arm became more moderate evening of day 1. Upper left arm is now back to mild pain/soreness on day 2. Would not want to rotate left arm right now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Pain is extremely mild now. Just a very slight sore in the left arm near the shot area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swelling in left armpit (had shot in left deltoid)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Middle insomnia, Night sweats — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild pain in left armpit continues. Woke up in middle of night. Had night sweat while sleeping last night. Temperature was about 98.5.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Pain — Feeling: Good · Site: Pain

Free text: The pain in the injection site is very mild (just feel it slightly when rotating arm).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling

Free text: Pain and swelling in armpit (shot arm)

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling

Free text: Shot arm, armpit still swelling and sore. Slightly better than yesterday.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-03
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna
3	2021-12-03	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Pain in upper left arm became more moderate evening of day 1. Upper left arm is now back to mild pain/soreness on day 2. Would not want to rotate left arm right now.

2021-03-23

Systemic reaction (other): Pain is extremely mild now. Just a very slight sore in the left arm near the shot area.

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Swelling in left armpit (had shot in left deltoid)

2021-04-19

Systemic reaction (other): Mild pain in left armpit continues. Woke up in middle of night. Had night sweat while sleeping last night. Temperature was about 98.5.

2021-04-21

Systemic reaction (other): The pain in the injection site is very mild (just feel it slightly when rotating arm).

Release 10 — days 1–6 daily, dose 3

2021-12-05

Systemic reaction (other): Pain and swelling in armpit (shot arm)

2021-12-06

Systemic reaction (other): Shot arm, armpit still swelling and sore. Slightly better than yesterday.

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
SRO	Axillary pain	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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