Z59-26169-09381

2 vaccinations 13 coded responses 24 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 076 / NJ
Registered: 2021-03-11

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

2021-03-10
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Electric shock sensation — Feeling: Good

Free text: Tiny electric like shocks in legs and arms/hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Shock symptom — Feeling: Good

Free text: Same electric like stings occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Electric shock sensation — Feeling: Good

Free text: Same electric like stings occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Electric shock sensation — Feeling: Good

Free text: Continue to have those little electric like stings occasionally through my body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Muscle or body aches

Free text: Still electric like stings occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 1
MedDRA: Electric shock sensation — Feeling: Good

Free text: Same electric like stings occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Health check-in — day 0, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Electric like stings every so often

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Electric shock sensation, Pain — Feeling: Good

Free text: Tiny electric like stings every so often

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 7, dose 2
MedDRA: Electric shock sensation, Pain — Feeling: Good

Free text: Electrical like stings occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 14, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Actually the injection site started to hurt couple days ago and still every so often it flares up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Survey response — day 35, dose 2
MedDRA: Electric shock sensation, Pain — Feeling: Good

Free text: Electric like stings/shocks throughout the body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-11
Survey response — 3 months, dose 2
MedDRA: Bladder disorder, Flank pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Flank pain and bladder pressure · Healthcare visit (other): Regular GP and urologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-20
Call 1 — Left Voicemail
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Bladder discomfort, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Discomfort in the region of my bladder. Had a whole bladder and kidney work up and everything is normal. · Healthcare visit (other): Went to urologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-07
Call 1 — Could Not Reach Participant
2021-10-12
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-07-11	Unsuccessful
2021-10-06	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Tiny electric like shocks in legs and arms/hands

2021-03-13

Systemic reaction (other): Same electric like stings occasionally

2021-03-14

Systemic reaction (other): Same electric like stings occasionally

2021-03-15

Systemic reaction (other): Continue to have those little electric like stings occasionally through my body

2021-03-16

Systemic reaction (other): Still electric like stings occasionally

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Same electric like stings occasionally

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Electric like stings every so often

2021-04-13

Systemic reaction (other): Tiny electric like stings every so often

Release 7 — day 7, dose 2

2021-04-14

Systemic reaction (other): Electrical like stings occasionally

Release 7 — day 14, dose 2

2021-04-21

Symptoms: Actually the injection site started to hurt couple days ago and still every so often it flares up

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Electric like stings/shocks throughout the body

Release 9 — 3 months, dose 2

2021-07-11

Symptoms: Flank pain and bladder pressure

Healthcare visit (other): Regular GP and urologist

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Discomfort in the region of my bladder. Had a whole bladder and kidney work up and everything is normal.

Healthcare visit (other): Went to urologist

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	✓	✓	✓
SD	Bladder discomfort	·	·	✓
SD	Bladder disorder	✓	✓	✓
SD	Electric shock sensation	✓	✓	✓
SD	Flank pain	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Shock symptom	✓	✓	✓

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