6XH-14420-78174

3 vaccinations 9 coded responses 21 check-ins 8 free-text entries 2 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 063 / CT
Registered: 2021-03-27

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

2021-03-27
Registered in v-safe
2021-03-27
Dose 1 — Moderna
2021-03-27
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Injection site tender to touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea

Free text: I have the little bumps and now on both sides of my neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: My Right arm is very sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: RT arm is sore from shot nothing else

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Survey response — day 14, dose 2
MedDRA: Muscle spasms — Feeling: Good · Be unable to do your normal daily activities

Free text: Muscle spasms on injection side. They are still pretty strong but getting better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-05
Dose 3 — Moderna
2022-04-24
Survey response — 12 months, dose 2
MedDRA: Arthritis, Brain fog, Fatigue, Glucose tolerance impaired, Rheumatoid arthritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Brain fog, inflammation in joints now I have RA, pre diabetic. I get tired all the time

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-05
Survey response — 3 months, dose 3
MedDRA: Glucose tolerance impaired, Pain, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have RA. Pre diabetic body hurts

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Survey response — 6 months, dose 3
MedDRA: Anxiety, Omental infarction, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have been diagnosed with severe rheumatoid arthritis. I had an ornamental infarction . Anxiety through the roof

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-06
Call successful
Participant prefers to complete VAERS report online
2023-03-05
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Back pain, Gastrointestinal disorder, Glucose tolerance impaired, Joint swelling, Pain in extremity, Rheumatoid arthritis — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2022-03-05	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-27

Systemic reaction (other): Injection site tender to touch

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): I have the little bumps and now on both sides of my neck

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): My Right arm is very sore

2021-04-27

Systemic reaction (other): RT arm is sore from shot nothing else

Release 8 — day 14, dose 2

2021-05-08

Symptoms: Muscle spasms on injection side. They are still pretty strong but getting better

Release 11 — 12 months, dose 2

2022-04-24

Symptoms: Brain fog, inflammation in joints now I have RA, pre diabetic. I get tired all the time

Release 11 — 3 months, dose 3

2022-06-05

Symptoms: I have RA. Pre diabetic body hurts

Release 12 — 6 months, dose 3

2022-09-03

Symptoms: I have been diagnosed with severe rheumatoid arthritis. I had an ornamental infarction . Anxiety through the roof

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	Anxiety	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	·	·	✓
SD	Back pain	·	·	✓
SD	Brain fog	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Glucose tolerance impaired	·	·	✓
SD	Joint swelling	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Omental infarction	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Swelling	✓	✓	✓

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