6SB-72847-72369

4 vaccinations 7 coded responses 33 check-ins 7 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 778 / TX
Registered: 2021-03-08

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Minor soreness at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Myalgia — Feeling: Good · Joint pains, Muscle or body aches

Free text: Stomach area / minor ab muscle aching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Adverse reaction, Inflammation, Myalgia, Office visit — Feeling: Good · Joint pains, Muscle or body aches, Abdominal pain · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Ab pain caused my primary doc to have an ultrasound done on me yesterday. Seems this 1st COVID shot has started muscle aches and inflammation to slowly worsen over time. · Healthcare visit (other): Havent reported my reaction to the vaccine the last two days as Ive been visiting with my doctor regarding reactions Ive been experiencing to see if they are related to the immunization or something already underway in my body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Myalgia — Feeling: Good · Muscle or body aches, Abdominal pain

Free text: Muscle and ab pain is very minor today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 7, dose 1
MedDRA: Myalgia, Tenderness — Feeling: Good · Muscle or body aches, Abdominal pain

Free text: Very minimal ab muscle pain....more like tenderness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 28, dose 1
MedDRA: Abdominal pain, Abdominal pain upper, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Still having a band of gut pain / pressure feeling in abdomen area. Local doctors testing and treating for two small blood clots identified in gut area veins in a CAT scan.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-12
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — day 42, dose 2
MedDRA: Gastrointestinal pain — Feeling: Good

Free text: Gut pain is back again, although not as intense as it was right after my 1st Moderna shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Call 1 — Left Voicemail
2021-06-16
Call 1 — Left Voicemail
2021-06-21
Call successful
Participant prefers to complete VAERS report online
2021-06-21
Call successful
Participant prefers to complete VAERS report online
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-21
Dose 3 — Moderna
2022-07-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-01
Dose 4 — Moderna
2022-12-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-14	Moderna
3	2022-01-21	Moderna	No
4	2022-12-01	Moderna	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): Minor soreness at injection site

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Stomach area / minor ab muscle aching

2021-03-12

Systemic reaction (other): Ab pain caused my primary doc to have an ultrasound done on me yesterday. Seems this 1st COVID shot has started muscle aches and inflammation to slowly worsen over time.

Healthcare visit (other): Havent reported my reaction to the vaccine the last two days as Ive been visiting with my doctor regarding reactions Ive been experiencing to see if they are related to the immunization or something already underway in my body.

2021-03-14

Systemic reaction (other): Muscle and ab pain is very minor today

Release 5 — day 7, dose 1

2021-03-15

Systemic reaction (other): Very minimal ab muscle pain....more like tenderness.

Release 6 — day 28, dose 1

2021-04-05

Symptoms: Still having a band of gut pain / pressure feeling in abdomen area. Local doctors testing and treating for two small blood clots identified in gut area veins in a CAT scan.

Release 8 — day 42, dose 2

2021-05-28

Symptoms: Gut pain is back again, although not as intense as it was right after my 1st Moderna shot.

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	Adverse reaction	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Gastrointestinal pain	✓	✓	✓
SD	Office visit	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Tenderness	✓	✓	○

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