Y83-20444-42526

2 vaccinations 11 coded responses 26 check-ins 11 free-text entries 5 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 154 / PA
Registered: 2021-01-29

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

Timeline

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

2021-01-28
Dose 1 — Moderna
2021-01-29
Registered in v-safe
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Free text: I have chronic pain, but there was no place to indicate a chronic condition being exacerbated. My joint pain and muscle cramping are above moderate today. Additionally, I havefor the first timefelt prickling neuropathic pain at shoulder, back of non-injection arm and neck area. Likely all is unrelated to vaccine. Just reporting what I feel.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Joint pains · Be unable to do your normal daily activities

Free text: I have chronic pain. This is not likely associated with vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — day 7, dose 1
MedDRA: Pain, Pre-existing disease — Feeling: Fair · Joint pains

Free text: Likely due to ongoing chronic pain flare up and not vaccine related. Just reporting facts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-25
Survey response — day 28, dose 1
MedDRA: Oedema — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Edema. Not likely vaccine related. Just reporting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-01
Dose 2 — Moderna
2021-03-01
Survey response — day 0, dose 2
MedDRA: Pain, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Unlikely related to vaccine. I have chronic pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Joint stiffness, Pain, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: In past reports I noted that pain was probably my chronic pain. This is different. This feels directly related to vaccine. Injection arm and shoulder joint and elbow joint are painful and stiff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Abdominal pain

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-15
Survey response — day 14, dose 2
MedDRA: Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Chronic pain and digestive issues unrelated to vaccine. · Healthcare visit (other): Primary doctor visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Survey response — day 21, dose 2
MedDRA: Blood pressure increased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Increased BP not likely related to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-12
Survey response — day 42, dose 2
MedDRA: Arthralgia, Myalgia, Unevaluable event — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscle and joint pain. · Healthcare visit (other): Primary care doc

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-15
Call 1 — Left Voicemail
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Malaise, Nasal congestion, Pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have a slight fever today, body aches, stuffy nose and some congestion in the area of my trachea. It funny that today of all days I get a check in from the cdc. Im sick, but do not know if its covid.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Asthenia, Brain fog, COVID-19, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Got Covid in August 2021. I am thankful it did not go to my lungs. Mostly severe pain. Worst I have ever been ill in my life. I had both shots before covid. Covid brain fog is difficult to deal with. I also have not returned to former energy level.

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-03-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-25	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-15	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-22	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-04-12	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-01	Successful 2022-03-02	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I have chronic pain, but there was no place to indicate a chronic condition being exacerbated. My joint pain and muscle cramping are above moderate today. Additionally, I havefor the first timefelt prickling neuropathic pain at shoulder, back of non-injection arm and neck area. Likely all is unrelated to vaccine. Just reporting what I feel.

2021-02-03

Systemic reaction (other): I have chronic pain. This is not likely associated with vaccine.

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): Likely due to ongoing chronic pain flare up and not vaccine related. Just reporting facts.

Release 4 — day 28, dose 1

2021-02-25

Symptoms: Edema. Not likely vaccine related. Just reporting.

Release 4 — day 0, dose 2

2021-03-01

Systemic reaction (other): Unlikely related to vaccine. I have chronic pain.

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): In past reports I noted that pain was probably my chronic pain. This is different. This feels directly related to vaccine. Injection arm and shoulder joint and elbow joint are painful and stiff.

Release 5 — day 14, dose 2

2021-03-15

Symptoms: Chronic pain and digestive issues unrelated to vaccine.

Healthcare visit (other): Primary doctor visit.

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Increased BP not likely related to vaccine.

Release 7 — day 42, dose 2

2021-04-12

Symptoms: Muscle and joint pain.

Healthcare visit (other): Primary care doc

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: I have a slight fever today, body aches, stuffy nose and some congestion in the area of my trachea. It funny that today of all days I get a check in from the cdc. Im sick, but do not know if its covid.

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Got Covid in August 2021. I am thankful it did not go to my lungs. Mostly severe pain. Worst I have ever been ill in my life. I had both shots before covid. Covid brain fog is difficult to deal with. I also have not returned to former energy level. cut off by CDC

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Blood pressure increased	✓	✓	✓
SD	Brain fog	·	·	✓
SD	COVID-19	·	·	✓
SD	Increased upper airway secretion	○	·	○
SD	Malaise	✓	·	✓
SD	Myalgia	✓	✓	✓
SD	Nasal congestion	✓	·	✓
SD	Oedema	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Respiratory tract congestion	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Joint stiffness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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