ZLZ-87387-86575

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 750 / TX
Registered: 2021-03-23

Relationship: Self
Race: Other
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

2021-03-22
Dose 1 — Moderna
2021-03-23
Registered in v-safe
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension, Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: High blood pressure,athritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Lacrimation increased, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Watery eyes and stuffy nose with a sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: My hands,feet,rists and ankles hurt the most.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Diarrhea

Adult check-in
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Diarrhea

Adult check-in
2021-04-05
Survey response — day 14, dose 1
MedDRA: Arthralgia, Back pain, Neck pain — Feeling: Good

Free text: My lower back aches at my tailbone area on either side of my spine,my shoulders,at the base of my neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-23
Dose 2 — Moderna
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Back pain, Bone pain, Musculoskeletal pain — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Severe pain in my back. Between my shoulder blades,knees and collar bones.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Musculoskeletal pain — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in between my shoulder blades and my knees.

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: Fair · Site: Pain · Headache, Joint pains · Be unable to do your normal daily activities

Free text: On my back still.

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, Pain in extremity — Feeling: Fair · Site: Swelling · Headache, Joint pains

Free text: Little pain in my knees and arms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling · Joint pains

Adult check-in
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 21, dose 2
MedDRA: Arthralgia, Musculoskeletal stiffness — Feeling: Good

Free text: I still have pain in my shoulders. They are really stiff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-23	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): High blood pressure,athritis

2021-03-24

Systemic reaction (other): Watery eyes and stuffy nose with a sore throat.

2021-03-26

Systemic reaction (other): My hands,feet,rists and ankles hurt the most.

Release 6 — day 14, dose 1

2021-04-05

Symptoms: My lower back aches at my tailbone area on either side of my spine,my shoulders,at the base of my neck.

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Severe pain in my back. Between my shoulder blades,knees and collar bones.

2021-04-27

Systemic reaction (other): Pain in between my shoulder blades and my knees.

2021-04-28

Systemic reaction (other): On my back still.

2021-04-29

Systemic reaction (other): Little pain in my knees and arms.

Release 8 — day 21, dose 2

2021-05-14

Symptoms: I still have pain in my shoulders. They are really stiff.

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	Back pain	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Neck pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Bone pain	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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