ZML-30004-52201

3 vaccinations 8 coded responses 31 check-ins 8 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 780 / TX
Registered: 2021-02-08

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

2021-02-08
Registered in v-safe
2021-02-08
Dose 1 — Moderna
2021-02-08
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Diarrhea

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: No

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

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-07
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Im getting more tired and sometimes i feel useless.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-08
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: My upper left leg connected to my hip gives me a lot of pain while I lay down all night, nothing helps to stop pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Dose 3 — Moderna
2021-11-01
Survey response — day 7, dose 3
MedDRA: Hot flush — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Hot flashes

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-13
Survey response — day 21, dose 3
MedDRA: Ear pain — Feeling: Fair

Free text: I have a terrible ear ache.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-04
Survey response — day 42, dose 3
MedDRA: Arthralgia, Insomnia — Feeling: Fair · Be unable to do your normal daily activities

Free text: All my joints hurt unable to sleep at nights

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Electric shock sensation, Limb discomfort, Muscle spasms, Musculoskeletal discomfort, Office visit, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left side from my hip to my ankle i get spasms like lightning bolts going down my leg very uncomfortable and painful. · Healthcare visit (other): VA health

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-23
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left hip doesn't allow me to lay flat on bed hurts real bad only when I lay down I'm fine standing up, my right wristbhurts also. · Healthcare visit (other): Va counsel

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-25
Call 1 — Could Not Reach Participant
2022-04-28
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-08	Moderna
3	2021-10-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-24	Unsuccessful
2022-04-23	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): No

Release 8 — 3 months, dose 2

2021-06-07

Symptoms: Im getting more tired and sometimes i feel useless.

Release 9 — 6 months, dose 2

2021-09-08

Symptoms: My upper left leg connected to my hip gives me a lot of pain while I lay down all night, nothing helps to stop pain

Release 10 — day 7, dose 3

2021-11-01

Systemic reaction (other): Hot flashes

Release 10 — day 21, dose 3

2021-11-13

Symptoms: I have a terrible ear ache.

Release 10 — day 42, dose 3

2021-12-04

Symptoms: All my joints hurt unable to sleep at nights

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: My left side from my hip to my ankle i get spasms like lightning bolts going down my leg very uncomfortable and painful.

Healthcare visit (other): VA health

Release 11 — 6 months, dose 3

2022-04-23

Symptoms: My left hip doesn't allow me to lay flat on bed hurts real bad only when I lay down I'm fine standing up, my right wristbhurts also.

Healthcare visit (other): Va counsel

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Ear pain	·	·	✓
SD	Electric shock sensation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Limb discomfort	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Musculoskeletal discomfort	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Hot flush	·	·	✓
SRO	No adverse event	✓	✓	✓

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