ZSP-53653-64075

3 vaccinations 8 coded responses 32 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 31-35
ZIP prefix: 983 / WA
Registered: 2021-03-20

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain, Swelling

Free text: mild momentary dizziness, seems to have subsided now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Pain in extremity, Renal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: kidney pain, armpit pain, forearm pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness

Free text: there is still something swollen in my left armpit, same arm as the deltoid of the injection, not constant pain anymore, but still hurts when I apply deodorant or when I reach up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Apathy, Libido decreased, Lymph node pain, Lymphadenopathy — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I still have swollen glands in my left armpit that hurt when pressed upon or when I try to do push-ups. My 2nd dose was injected into my left deltoid. I have been feeling extremely unmotivated since my 2nd dose, also greatly decreased libido.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Apathy, Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness

Free text: I still have some swollen glands in my left armpit. I still feel very unmotivated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Apathy, Lymphadenopathy — Feeling: Fair · Fatigue or tiredness

Free text: I still have some swollen glands in my left armpit, but it is less than before. Still feeling less motivated than normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness

Free text: The swollen glands in my left armpit are finally going away, but not entirely back to normal yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Dose 3 — Moderna
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-02
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2021-11-09
Health check-in — day 35, dose 3
Feeling: Poor

Adult check-in
2021-11-16
Health check-in — day 42, dose 3
Feeling: Poor

Adult check-in
2022-01-04
Survey response — 3 months, dose 3
MedDRA: Adverse reaction, Exposure to SARS-CoV-2, SARS-CoV-2 test negative — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: covid exposure on 12/25, almost everyone got it, im pretty sure i did too, but my test said i was negative, but i think it was a false negative, however, it was very mild and im overwhelming happy that i have my 3 doses of vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Report sent to call center — 3 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-05
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-05
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna
3	2021-10-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-04	Successful 2022-01-06	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7 — day 0, dose 2

2021-04-17

Systemic reaction (other): mild momentary dizziness, seems to have subsided now

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): kidney pain, armpit pain, forearm pain

2021-04-20

Systemic reaction (other): there is still something swollen in my left armpit, same arm as the deltoid of the injection, not constant pain anymore, but still hurts when I apply deodorant or when I reach up

2021-04-21

Systemic reaction (other): I still have swollen glands in my left armpit that hurt when pressed upon or when I try to do push-ups. My 2nd dose was injected into my left deltoid. I have been feeling extremely unmotivated since my 2nd dose, also greatly decreased libido.

2021-04-22

Systemic reaction (other): I still have some swollen glands in my left armpit. I still feel very unmotivated.

2021-04-23

Systemic reaction (other): I still have some swollen glands in my left armpit, but it is less than before. Still feeling less motivated than normal.

Release 7 — day 7, dose 2

2021-04-24

Systemic reaction (other): The swollen glands in my left armpit are finally going away, but not entirely back to normal yet.

Release 10 — 3 months, dose 3

2022-01-04

Symptoms: covid exposure on 12/25, almost everyone got it, im pretty sure i did too, but my test said i was negative, but i think it was a false negative, however, it was very mild and im overwhelming happy that i have my 3 doses of vaccine

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	Adverse reaction	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Apathy	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Libido decreased	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Renal pain	✓	✓	✓

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