3M5-77048-72748

3 vaccinations 6 coded responses 26 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 954 / CA
Registered: 2021-05-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-02
Dose 1 — Moderna
2021-04-30
Dose 2 — Moderna
2021-05-05
Registered in v-safe
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-05-07
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-05-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-06
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 42, dose 2
MedDRA: Fatigue, Lymphadenopathy — Feeling: Fair · 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: Fatigue, enlarged inguinal lymph node verified by US, noticed on 4/28

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call 1 — Left Voicemail
2021-07-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Back 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: Joint pain, back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-01
Call successful
Does not wish to fill out VAERS report
2021-11-01
Call successful
Does not wish to fill out VAERS report
2021-11-18
Dose 3 — Moderna
2021-11-18
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-25
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-12-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Survey response — day 35, dose 3
MedDRA: Dry mouth, Enlarged uvula — Feeling: Good

Free text: Excessive Dry mouth, swollen uvula

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-19
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Diarrhoea, Fatigue, Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme headache, fatigue, joint pain, diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Survey response — 12 months, dose 3
MedDRA: Arthralgia, COVID-19, Eczema, Infected cyst — Feeling: Good · 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

Free text: Covid 9/2022, eczema, joint pain, infected cysts

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Report sent to call center — 12 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 · 1 call case(s)
2022-11-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-02	Moderna
2	2021-04-30	Moderna
3	2021-11-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-11	Successful 2021-11-01	Does not wish to fill out VAERS report
2021-10-29	Successful 2021-11-01	Does not wish to fill out VAERS report
2022-11-18	Unsuccessful

Free text

Release 8 — day 35, dose 2

2021-06-06

Symptoms: Headache

Release 9 — day 42, dose 2

2021-06-11

Symptoms: Fatigue, enlarged inguinal lymph node verified by US, noticed on 4/28

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: Joint pain, back pain

Release 10 — day 35, dose 3

2021-12-23

Symptoms: Excessive Dry mouth, swollen uvula

Release 11 — 6 months, dose 3

2022-05-19

Symptoms: Extreme headache, fatigue, joint pain, diarrhea

Release 12 — 12 months, dose 3

2022-11-18

Symptoms: Covid 9/2022, eczema, joint pain, infected cysts

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	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dry mouth	·	·	✓
SD	Eczema	·	·	✓
SD	Enlarged uvula	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Infected cyst	·	·	✓
SD	Lymphadenopathy	✓	✓	✓

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