Y76-23528-79205

2 vaccinations 5 coded responses 25 check-ins 5 free-text entries 3 call cases

Sex: Male
Age at first dose: 31-35
ZIP prefix: 100 / NY
Registered: 2021-01-16

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

2021-01-16
Registered in v-safe
2021-01-16
Dose 1 — Moderna
2021-01-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Survey response — day 14, dose 1
MedDRA: Arthralgia, Injection site erythema, Injection site warmth, Neck pain, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Injection site redness went away but then came back (also warm to the touch). Additionally, developed soreness in neck/shoulder which seems to kind of radiate down right arm (which is the injected arm). But may be musculoskeletal and unrelated to vax

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-13
Survey response — day 28, dose 1
MedDRA: Muscular weakness — Feeling: Good

Free text: Possibly some weakness in my right arm/shoulder in addition to the pin I previously reported. May be unrelated to the vaccine as I had something similar happen a few years ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Dose 2 — Moderna
2021-02-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good · Site: Pain

Free text: some back pain (probably not related to the vaccine?)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Nausea

Free text: Mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-02-19
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Survey response — day 14, dose 2
MedDRA: Arthralgia, Back pain, Muscle fatigue, Muscle tightness, Neck pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Neck/shoulder/back pain, some limb fatigue and muscle tightness · Healthcare visit (other): Scheduled neurologist visit for 3/3/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-31
Call 1 — Could Not Reach Participant
2021-06-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-15
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-30	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-02-19	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-02-28	Successful 2021-06-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — day 14, dose 1

2021-01-30

Symptoms: Injection site redness went away but then came back (also warm to the touch). Additionally, developed soreness in neck/shoulder which seems to kind of radiate down right arm (which is the injected arm). But may be musculoskeletal and unrelated to vax cut off by CDC

Release 4 — day 28, dose 1

2021-02-13

Symptoms: Possibly some weakness in my right arm/shoulder in addition to the pin I previously reported. May be unrelated to the vaccine as I had something similar happen a few years ago.

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): some back pain (probably not related to the vaccine?)

2021-02-17

Systemic reaction (other): Mild dizziness

Release 4 — day 14, dose 2

2021-02-28

Symptoms: Neck/shoulder/back pain, some limb fatigue and muscle tightness

Healthcare visit (other): Scheduled neurologist visit for 3/3/21

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	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Muscle fatigue	✓	✓	✓
SD	Muscle tightness	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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