6A3-30890-39746
5 vaccinations
10 coded responses
55 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 841 / UT
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
-
2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: PainFree text: Arm ache spread from injection site to entire upper arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Injection site warmth — Feeling: Good · Site: PainFree text: Pain & warmth in deltoid muscle where I received the vaccine is diminishing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Injection site rash — Feeling: Good · Site: Pain, Redness · Rash, not including the immediate area around the injection siteFree text: I have a small, irregularly shaped rash on my "lower" bicep area in the arm that received the vaccine. The total area affected is about the size of a playing card, and it arose in patches, towards the distal end of the bicep on the front facing surface.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-01
- 2021-02-06
- 2021-02-13
-
2021-02-20
Dose 2 — Moderna
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2021-02-20
Survey response — day 0, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: a mild, dull, dispersed ache in the deltoid muscle that received the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal stiffness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Stiff neck.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash, Lethargy, Listless — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Listlessness & lethargy. A diffuse rash over much of the bicep that received the dose, distal from ("below") the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-06
- 2021-03-13
-
2021-03-20
Survey response — day 28, dose 2MedDRA: Ear discomfort, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I don't know if it's related, but since my second dose of the Moderna vaccine on 2/20/21, I have experienced a fullness in the inner ear of my left ear, and increased, non-pulsitile, high-pitched tinnitus in that same ear, resulting in a Dr. visit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-27
- 2021-04-03
- 2021-05-22
- 2021-08-21
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2021-11-19
Dose 3 — Moderna
- 2021-11-19
-
2021-11-20
Survey response — days 1–6 daily, dose 3MedDRA: Musculoskeletal stiffness, Neck pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Stiff & sore neck.MedDRA releases: 2024-11 · check-in free text available
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2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue — Feeling: Good · Site: PainFree text: Residual tiredness and fatigue is fading after a good night's rest last night.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-11-25
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2021-12-24
-
2021-12-28
Call successfulCompleted over the phone
- 2021-12-31
- 2022-02-18
-
2022-05-06
Dose 4 — Moderna
- 2022-05-06
-
2022-05-07
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2022-05-08
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-09
- 2022-05-10
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-20
- 2022-05-29
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-08-05
-
2022-10-08
Dose 5 — Moderna
- 2022-11-04
-
2023-04-08
Survey response — 6 months, dose 5MedDRA: COVID-19, Cough, Headache, Malaise, Musculoskeletal stiffness, Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-05-06 | Moderna | No |
| 5 | 2022-10-08 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Arm ache spread from injection site to entire upper arm.
Systemic reaction (other): Pain & warmth in deltoid muscle where I received the vaccine is diminishing.
Systemic reaction (other): I have a small, irregularly shaped rash on my "lower" bicep area in the arm that received the vaccine. The total area affected is about the size of a playing card, and it arose in patches, towards the distal end of the bicep on the front facing surface.
Release 4 — day 0, dose 2
Systemic reaction (other): a mild, dull, dispersed ache in the deltoid muscle that received the vaccine.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Stiff neck.
Systemic reaction (other): Listlessness & lethargy. A diffuse rash over much of the bicep that received the dose, distal from ("below") the injection site.
Release 6 — day 28, dose 2
Symptoms: I don't know if it's related, but since my second dose of the Moderna vaccine on 2/20/21, I have experienced a fullness in the inner ear of my left ear, and increased, non-pulsitile, high-pitched tinnitus in that same ear, resulting in a Dr. visit. cut off by CDC
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Stiff & sore neck.
Systemic reaction (other): Residual tiredness and fatigue is fading after a good night's rest last night.
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 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Lethargy | ✓ | ✓ | ✓ |
| SRO | Listless | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release