Z6E-17868-07791

4 vaccinations 13 coded responses 30 check-ins 13 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 100 / NY
Registered: 2021-02-26

Relationship: Self
Race: White
Ethnicity: Not 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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Survey response — day 0, dose 1
MedDRA: Pain — Feeling: Good · Site: Pain

Free text: Just that tiny pain I dont even notice till you asked

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Pain · Fever

Free text: Had neck stiffness on side of shot yesterday, totally gone today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 21, dose 1
MedDRA: Neck pain — Feeling: Good

Free text: I have this slight soreness on the side of my neck on the jabbed side. I thought it went away but still a bit it I twist my head quickly or far to the left. All else okay.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Dose 2 — Moderna
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good

Free text: Yesterday I had 1 2 3 and 4. Today only tiny neck stiffness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Good · Muscle or body aches

Free text: Aches diminishing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Good · Muscle or body aches

Free text: My neck has somewhat of pains, not terrible but constant. I have a spot on my upper back/ shoulder that has been sensitive since day 1, was moreso but still quite noticeable if I lay down or sit on a chair with a high upholstered back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — day 7, dose 2
MedDRA: Back pain, Tenderness — Feeling: Good · Muscle or body aches

Free text: Still have a spot on my right back/shoulder since day after the shot, very tender, about 2 inches square.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-18
Survey response — day 21, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good

Free text: Since dose#1 I had a mild stiffness in the side of my neck on the injection side. I thought it was fading but I still have it. About a 4 out of 10.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-26
Survey response — 3 months, dose 2
MedDRA: Musculoskeletal stiffness, Paraesthesia — Feeling: Good

Free text: Several times a day I get a tingling in my neck from the ear to the shoulder feels like liquid running down but is none. Plus the muscle from ear to shoulder gets stiff for a few minutes 5 times a day. All on the vaccine shot side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-24
Dose 3 — Moderna
Co-administered: Flu
2022-05-02
Dose 4 — Moderna
2022-05-05
Survey response — days 1–6 daily, dose 4
MedDRA: Poor quality sleep — Feeling: Good · Fatigue or tiredness

Free text: Didn't sleep well

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-30
Survey response — day 28, dose 4
MedDRA: Body temperature increased — Feeling: Good

Free text: Today my temp is 98'7. It's almost never above 98.

MedDRA releases: 2024-11 · check-in free text available
2022-06-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-02
Survey response — 3 months, dose 4
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Head cold.

MedDRA releases: 2024-11 · check-in free text available
2023-05-02
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-11-24	Moderna	Flu
4	2022-05-02	Moderna	No

Free text

Release 4 — day 0, dose 1

2021-02-26

Systemic reaction (other): Just that tiny pain I dont even notice till you asked

Release 4 — days 1–6 daily, dose 1

2021-02-28

Systemic reaction (other): Had neck stiffness on side of shot yesterday, totally gone today.

Release 5 — day 21, dose 1

2021-03-19

Symptoms: I have this slight soreness on the side of my neck on the jabbed side. I thought it went away but still a bit it I twist my head quickly or far to the left. All else okay.

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Yesterday I had 1 2 3 and 4. Today only tiny neck stiffness.

2021-03-31

Systemic reaction (other): Aches diminishing.

2021-04-01

Systemic reaction (other): My neck has somewhat of pains, not terrible but constant. I have a spot on my upper back/ shoulder that has been sensitive since day 1, was moreso but still quite noticeable if I lay down or sit on a chair with a high upholstered back.

Release 6 — day 7, dose 2

2021-04-04

Systemic reaction (other): Still have a spot on my right back/shoulder since day after the shot, very tender, about 2 inches square.

Release 7 — day 21, dose 2

2021-04-18

Symptoms: Since dose#1 I had a mild stiffness in the side of my neck on the injection side. I thought it was fading but I still have it. About a 4 out of 10.

Release 9 — 3 months, dose 2

2021-06-26

Symptoms: Several times a day I get a tingling in my neck from the ear to the shoulder feels like liquid running down but is none. Plus the muscle from ear to shoulder gets stiff for a few minutes 5 times a day. All on the vaccine shot side.

Release 11 — days 1–6 daily, dose 4

2022-05-05

Systemic reaction (other): Didn't sleep well

Release 11 — day 7, dose 4

2022-05-09

Systemic reaction (other): None

Release 11 — day 28, dose 4

2022-05-30

Symptoms: Today my temp is 98'7. It's almost never above 98.

Release 12 — 3 months, dose 4

2022-08-02

Symptoms: Head cold.

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	Body temperature increased	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Poor quality sleep	·	·	✓
SRO	Tenderness	✓	✓	✓

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