ZJK-20650-04112

3 vaccinations 15 coded responses 20 check-ins 15 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 983 / WA
Registered: 2021-02-02

Relationship: Self
Race: Multiracial
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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches

Free text: I just had lower back surgery, so my back muscles are sore from the surgery January 8th, otherwise I feel fine

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: Feeling hot, Injection site pain, Injection site warmth, Pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Arm around injection (around 6 inches in circumference) was hot to the touch last night. Normal today with exception of soreness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: Sore arm immediately around injection site. Typical flu vaccine ache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Arm still slightly sore below shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Muscle or body aches

Free text: Arm is still sore at site of injection in left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Muscle or body aches

Free text: Can still feel soreness around the injection site. It's been 5 days now since the injection. No other discomfort noted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Muscle or body aches

Free text: Arm still slightly sore. Not noticeable until I think about it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Good · Muscle or body aches

Free text: Arm still mildly sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Dose 2 — Moderna
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Gout, Hypersomnia, Injection site pain, Injection site swelling, Pre-existing disease, Somnolence — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Felt groggy after waking up today and eating breakfast. Slept in until almost noon. Arm is slightly swollen and sore at injection site. Might not be related, but experiencing gout pain in right knee, and right piriformis pain in right hip after recent lower back surgery.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Gout, Injection site pain, Injection site warmth, Sciatica — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Soreness and warmth at injection site. Most likely unrelated, but sciatica-like pain of right hip, and gout pain in right knee. Been taking prednisone for knee pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Emergency care, Gout, Headache, Joint effusion, Joint fluid drainage, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Went to hospital yesterday to have a gout attack checked on my right knee. Asked ER doctor to drain fluid off right knee. Uric Acid-normal and no uric acid crystals present. Wondering if immune system response from vaccine was supercharging my immune system. Took prednisone, iced knee and took oxycodone to get a good nights sleep. Had headache yesterday, not today. Dont know if any of this is relevant.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Gout — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Still dealing with gout pain in right knee, and hip pain that is nerve related, I believe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 7, dose 2
MedDRA: Bursitis, Emergency care, Joint swelling — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Went to emergency room yesterday. My right knee wasswollen and hasbeen for two weeks. Thought it was Gout. Turned out to be pre-patellar bursitisin my right knee. Felt like gout. Doctor said it could take a month to heal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-27
Dose 3 — Moderna
2021-08-28
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Back pain, Pain — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: General body aches. Sore shoulders, lower back, mid back.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Survey response — days 1–6 daily, dose 3
MedDRA: Pain — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: General Body Achiness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-03
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-09-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-18
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-09-24
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-10-01
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-02	Moderna
3	2021-08-27	Moderna	No

Free text

Release 3 — day 0, dose 1

2021-02-02

Systemic reaction (other): I just had lower back surgery, so my back muscles are sore from the surgery January 8th, otherwise I feel fine

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Arm around injection (around 6 inches in circumference) was hot to the touch last night. Normal today with exception of soreness.

2021-02-04

Systemic reaction (other): Sore arm immediately around injection site. Typical flu vaccine ache.

2021-02-05

Systemic reaction (other): Arm still slightly sore below shoulder

2021-02-06

Systemic reaction (other): Arm is still sore at site of injection in left arm.

2021-02-07

Systemic reaction (other): Can still feel soreness around the injection site. It's been 5 days now since the injection. No other discomfort noted.

2021-02-08

Systemic reaction (other): Arm still slightly sore. Not noticeable until I think about it.

Release 4 — day 7, dose 1

2021-02-10

Systemic reaction (other): Arm still mildly sore.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Felt groggy after waking up today and eating breakfast. Slept in until almost noon. Arm is slightly swollen and sore at injection site. Might not be related, but experiencing gout pain in right knee, and right piriformis pain in right hip after recent lower back surgery.

2021-03-04

Systemic reaction (other): Soreness and warmth at injection site. Most likely unrelated, but sciatica-like pain of right hip, and gout pain in right knee. Been taking prednisone for knee pain.

2021-03-06

Systemic reaction (other): Went to hospital yesterday to have a gout attack checked on my right knee. Asked ER doctor to drain fluid off right knee. Uric Acid-normal and no uric acid crystals present. Wondering if immune system response from vaccine was supercharging my immune system. Took prednisone, iced knee and took oxycodone to get a good nights sleep. Had headache yesterday, not today. Dont know if any of this is relevant.

2021-03-07

Systemic reaction (other): Still dealing with gout pain in right knee, and hip pain that is nerve related, I believe.

Release 5 — day 7, dose 2

2021-03-09

Systemic reaction (other): Went to emergency room yesterday. My right knee wasswollen and hasbeen for two weeks. Thought it was Gout. Turned out to be pre-patellar bursitisin my right knee. Felt like gout. Doctor said it could take a month to heal.

Release 9 — days 1–6 daily, dose 3

2021-08-28

Systemic reaction (other): General body aches. Sore shoulders, lower back, mid back.

2021-08-29

Systemic reaction (other): General Body Achiness

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
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	·	✓
SRO	Bursitis	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Feeling hot	✓	✓	○
SRO	Gout	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Joint effusion	✓	✓	✓
SRO	Joint fluid drainage	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Sciatica	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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