ZXC-22802-30948

2 vaccinations 6 coded responses 24 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 436 / OH
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Reaction to previous exposure to any vaccine, Somnolence — Feeling: Good · Site: Pain

Free text: Pain is similar to flu shot, fewer symptoms than with shingles vaccine. Took a 2 hour nap this afternoon. That is unusual but I feel okay.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Self-medication, Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: All relieved with ibuprofen 600mg every 6 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Self-medication — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Abdominal pain may be from ibuprofen every 6 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Survey response — day 21, dose 1
MedDRA: Back pain, Gait disturbance, Orthosis user, Tendon pain — Feeling: Fair · 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: Last week had increased lower back pain. This week I had severe pain in posterior tibial tendon that almost prevented me from work and barely able to walk to doctor appointment. A brace is helping and today began methyl-prednisone dose pack.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Good · Site: Pain · Headache

Free text: Arm pain and headache may be related to tetanus vaccination 2-8-2021 as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-06-10
Call 1 — Left Voicemail
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Body temperature increased, Chromaturia, Influenza virus test negative, Nasopharyngitis, Office visit, SARS-CoV-2 test negative, Urine abnormality — 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: Symptoms: January 1 onset severe cold. Antigen test day 2 for Covid negative. Also negative flu. Lasted 8 days. Only fever 200.2 on day 2. Third week January brown cloudy urine that continues. Began Cipro February 2, awaiting lab results urine test. · Healthcare visit (other): Urgent care for cold, pulmonologist later said likely Covid, PCP for urine

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
Report sent to call center — 12 months, dose 2
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)
2022-02-08
Call 1 — Could Not Reach Participant
2022-02-11
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Pain is similar to flu shot, fewer symptoms than with shingles vaccine. Took a 2 hour nap this afternoon. That is unusual but I feel okay.

2021-01-10

Systemic reaction (other): All relieved with ibuprofen 600mg every 6 hours

2021-01-11

Systemic reaction (other): Abdominal pain may be from ibuprofen every 6 hours

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Last week had increased lower back pain. This week I had severe pain in posterior tibial tendon that almost prevented me from work and barely able to walk to doctor appointment. A brace is helping and today began methyl-prednisone dose pack.

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Arm pain and headache may be related to tetanus vaccination 2-8-2021 as well

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: January 1 onset severe cold. Antigen test day 2 for Covid negative. Also negative flu. Lasted 8 days. Only fever 200.2 on day 2. Third week January brown cloudy urine that continues. Began Cipro February 2, awaiting lab results urine test.

Healthcare visit (other): Urgent care for cold, pulmonologist later said likely Covid, PCP for urine

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	Nasopharyngitis	·	·	✓
HCVO	Office visit	·	·	✓
SD	Back pain	✓	✓	✓
SD	Body temperature increased	·	·	✓
SD	Chromaturia	·	·	✓
SD	Gait disturbance	✓	✓	✓
SD	Influenza virus test negative	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Orthosis user	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Tendon pain	✓	✓	✓
SD	Urine abnormality	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Adverse reaction	✓	·	✓
SRO	Headache	✓	✓	✓
SRO	Nonspecific reaction	○	○	○
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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