YXA-28849-41603

2 vaccinations 12 coded responses 14 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 41-45
ZIP prefix: 106 / NY
Registered: 2021-02-10

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-15
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Survey response — day 21, dose 1
MedDRA: Arthralgia, Decreased appetite, Somnolence — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Achy joints, drowsiness, reduced appetite,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Dose 2 — Moderna
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Hypoaesthesia, Retching, Telemedicine — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, 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: Systemic reaction (other): Dry heaving, numbness in the left arm, loss of appetite · Healthcare visit (other): It was difficult doing a VA Telehealth appt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — days 1–6 daily, 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)
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Retching — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dry heaving, diarrhea like a yoo-hoo chocolate machine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: My appetite has disappeared though...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: It feels like im in an episode of South Park and I got explosive diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Survey response — day 7, dose 2
MedDRA: Joint swelling — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen knees similar to arthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 14, dose 2
MedDRA: Arthralgia, Joint swelling — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Joint pain, swelling in the knees

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 21, dose 2
MedDRA: Arthralgia, Swelling — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Swelling and arthritic pain in my knees

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 28, dose 2
MedDRA: Joint swelling, Mobility decreased, Sluggishness — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Knees still swollen like arthritis, difficult to kneel down and walk down stairsAnd still feeling sluggish

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort, Arthritis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Arthritis in knees, stomach issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 42, dose 2
MedDRA: Joint swelling — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen knees and joints

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-03
Call 1 — Left Voicemail
2022-02-13
Survey response — 12 months, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair

Free text: Lymph nodes under arms are enlarged but not painful

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-12	Unsuccessful

Free text

Release 4 — day 21, dose 1

2021-02-10

Symptoms: Achy joints, drowsiness, reduced appetite,

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Dry heaving, numbness in the left arm, loss of appetite

Healthcare visit (other): It was difficult doing a VA Telehealth appt

2021-02-13

Systemic reaction (other): Dry heaving, diarrhea like a yoo-hoo chocolate machine

2021-02-14

Systemic reaction (other): My appetite has disappeared though...

2021-02-16

Systemic reaction (other): It feels like im in an episode of South Park and I got explosive diarrhea

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Swollen knees similar to arthritis

Release 4 — day 14, dose 2

2021-02-25

Symptoms: Joint pain, swelling in the knees

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Swelling and arthritic pain in my knees

Release 5 — day 28, dose 2

2021-03-11

Symptoms: Knees still swollen like arthritis, difficult to kneel down and walk down stairsAnd still feeling sluggish

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Arthritis in knees, stomach issues

Release 6 — day 42, dose 2

2021-03-25

Symptoms: Swollen knees and joints

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Lymph nodes under arms are enlarged but not painful

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	Telemedicine	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Sluggishness	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Swelling	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Retching	✓	✓	✓

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