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ZPP-26446-27315

4 vaccinations 8 coded responses 53 check-ins 8 free-text entries 2 call cases
Sex
Male
Age at first dose
41-45
ZIP prefix
430 / OH
Registered
2021-03-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-20
    Registered in v-safe
  2. 2021-03-20
    Dose 1 — Moderna
  3. 2021-03-20
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-03-22
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Free text: A feeling of "brain fog" is the best that I could describe it
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  7. 2021-03-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-27
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  10. 2021-04-03
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-04-10
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-17
    Dose 2 — Moderna
  13. 2021-04-17
    Health check-in — day 0, dose 2
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  14. 2021-04-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-04-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Abnormal dreams — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness
    Free text: Very vivid dreams started again at about 41 hours in
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  17. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-24
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-01
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-08
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-15
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-22
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-29
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-07-17
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-10-16
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-11-19
    Dose 3 — Pfizer-BioNTech
  28. 2021-11-19
    Survey response — day 0, dose 3
    MedDRA: Injection site reaction, Muscle spasms, Muscle twitching — Feeling: Fair · Headache, Fatigue or tiredness
    Free text: Sporadically Twitching/Spasm at injection site
    MedDRA releases: 2024-11 · check-in free text available
  29. 2021-11-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school
    Adult check-in
  30. 2021-11-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  31. 2021-11-22
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Fair
    Free text: Swelling in my armpit on injection arm. Likely lymph node
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-11-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Oedema peripheral — Feeling: Good · Headache
    Free text: Swelling in armpit still present. No pain today.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-11-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  34. 2021-11-25
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-11-26
    Health check-in — day 7, dose 3
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  36. 2021-12-05
    Survey response — day 14, dose 3
    MedDRA: Arthralgia, Muscle spasms, Oedema peripheral, Pain, Pain in extremity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: The spasms in my arm and swelling in armpit may have caused a knot or dense spasm beneath my shoulder blade. Excessive local pain and radiant pain from shoulder thru hand. May be unrelated, but no notable event or injury to explain the circumstances.
    MedDRA releases: 2024-11 · check-in free text available
  37. 2021-12-05
    Report sent to call center — day 14, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  38. 2021-12-08
  39. 2021-12-13
    Survey response — day 21, dose 3
    MedDRA: Injection site reaction, Muscle spasms, Muscle swelling — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Spasms down the side of my rib cage beneath my armpit of injection arm. Along with continued spasms in the deltoid at injection site and beneath shoulder blade. The new spasms have caused some swelling in the muscles along my abdomen area.
    MedDRA releases: 2024-11 · check-in free text available
  40. 2021-12-19
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  41. 2021-12-26
    Survey response — day 35, dose 3
    MedDRA: Abdominal distension, Abdominal pain, Emergency care, Muscle spasms, Myositis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: The swelling in my abdomen became larger and more painful. Ended up in ER for a multitude of blood and urine tests. A CT scan revealed no organ issues . Recommended ibuprofen for muscle inflammation. Same area as spasms have occurred since booster.
    MedDRA releases: 2024-11 · check-in free text available
  42. 2021-12-26
    Report sent to call center — day 35, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Emergency room or emergency department visit · 1 call case(s)
  43. 2021-12-28
    Call successful
    Participant prefers to complete VAERS report online
  44. 2021-12-31
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  45. 2022-02-18
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  46. 2022-05-24
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  47. 2022-12-20
    Dose 4 — Moderna
    Co-administered: Flu
  48. 2022-12-20
    Health check-in — day 0, dose 4
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  49. 2022-12-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  50. 2022-12-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Poor · Site: Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  51. 2022-12-23
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Chills
    Adult check-in
  52. 2022-12-24
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  53. 2022-12-25
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  54. 2022-12-26
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Chills
    Adult check-in
  55. 2022-12-27
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  56. 2023-01-03
    Health check-in — day 14, dose 4
    Feeling: Poor
    Adult check-in
  57. 2023-01-10
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  58. 2023-01-19
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  59. 2023-01-24
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  60. 2023-01-31
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  61. 2023-03-21
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  62. 2023-06-20
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-20Moderna
22021-04-17Moderna
32021-11-19Pfizer-BioNTech No
42022-12-20Moderna Flu

Call center

ReportedOutcomeVAERS-related outcome
2021-12-05 Successful Participant prefers to complete VAERS report online
2021-12-26 Successful
2021-12-28
 Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): A feeling of "brain fog" is the best that I could describe it

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Very vivid dreams started again at about 41 hours in

Release 10 — day 0, dose 3

2021-11-19

Systemic reaction (other): Sporadically Twitching/Spasm at injection site

Release 10 — days 1–6 daily, dose 3

2021-11-22

Systemic reaction (other): Swelling in my armpit on injection arm. Likely lymph node

2021-11-23

Systemic reaction (other): Swelling in armpit still present. No pain today.

Release 10 — day 14, dose 3

2021-12-05

Symptoms: The spasms in my arm and swelling in armpit may have caused a knot or dense spasm beneath my shoulder blade. Excessive local pain and radiant pain from shoulder thru hand. May be unrelated, but no notable event or injury to explain the circumstances. cut off by CDC

Release 10 — day 21, dose 3

2021-12-13

Symptoms: Spasms down the side of my rib cage beneath my armpit of injection arm. Along with continued spasms in the deltoid at injection site and beneath shoulder blade. The new spasms have caused some swelling in the muscles along my abdomen area.

Release 10 — day 35, dose 3

2021-12-26

Symptoms: The swelling in my abdomen became larger and more painful. Ended up in ER for a multitude of blood and urine tests. A CT scan revealed no organ issues . Recommended ibuprofen for muscle inflammation. Same area as spasms have occurred since booster. cut off by CDC

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

FieldPreferred term2021-092023-042024-11
SDAbdominal distension · · ✓
SDAbdominal pain · · ✓
SDArthralgia · · ✓
SDEmergency care · · ✓
SDInjection site reaction · · ✓
SDMuscle spasms · · ✓
SDMuscle swelling · · ✓
SDMyositis · · ✓
SDOedema peripheral · · ✓
SDPain · · ✓
SDPain in extremity · · ✓
SROAbnormal dreams ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROInjection site reaction · · ✓
SROLymphadenopathy · · ✓
SROMuscle spasms · · ✓
SROMuscle twitching · · ✓
SROOedema peripheral · · ✓

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

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