Z3C-23836-42390

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 0 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 773 / TX
Registered: 2021-03-30

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-29
Dose 1 — Moderna
2021-03-30
Registered in v-safe
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Moderna
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Left elbow so painful where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Lot of in the left elbow where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Lot of pain in the left elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Headache

Free text: Moderate pain in left elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Joint pains

Free text: Pain in the left elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 7, dose 2
MedDRA: Arthralgia — Feeling: Fair · Joint pains

Free text: Pain in my left elbow in the arm where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — day 14, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Pain on left elbow in the arm where I received the vaccines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Survey response — day 28, dose 2
MedDRA: Arthralgia, Ocular discomfort — Feeling: Good

Free text: Pain in the left elbow and information in left eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Pain in left elbow arm where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Survey response — day 42, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: After the vacation I am experiencing pain in my left elbow. Sin that I didnt have before. is getting worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-28
Survey response — 3 months, dose 2
MedDRA: Injection site joint pain — Feeling: Fair

Free text: After I received the shots in my left elbow I had pain and very slowly but is getting worse. No body from your organization has called me so why you people keeps asking me how am I doing.!

MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-29	Moderna
2	2021-04-26	Moderna

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): Left elbow so painful where I received the vaccine

2021-04-28

Systemic reaction (other): Lot of in the left elbow where I received the vaccine

2021-04-29

Systemic reaction (other): Lot of pain in the left elbow

2021-04-30

Systemic reaction (other): Moderate pain in left elbow

2021-05-01

Systemic reaction (other): Pain in the left elbow

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): Pain in my left elbow in the arm where I received the vaccine

Release 8 — day 14, dose 2

2021-05-10

Symptoms: Pain on left elbow in the arm where I received the vaccines

Release 8 — day 28, dose 2

2021-05-24

Symptoms: Pain in the left elbow and information in left eye

Release 8 — day 35, dose 2

2021-05-31

Symptoms: Pain in left elbow arm where I received the vaccine

Release 8 — day 42, dose 2

2021-06-09

Symptoms: After the vacation I am experiencing pain in my left elbow. Sin that I didnt have before. is getting worse.

Release 9 — 3 months, dose 2

2021-07-28

Symptoms: After I received the shots in my left elbow I had pain and very slowly but is getting worse. No body from your organization has called me so why you people keeps asking me how am I doing.!

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	Arthralgia	✓	✓	✓
SD	Injection site joint pain	✓	·	✓
SD	Ocular discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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