3XA-16253-05079

1 vaccination 8 coded responses 15 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 761 / TX
Registered: 2021-01-26

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Diarrhea

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-02-09
Survey response — day 14, dose 1
MedDRA: Biliary colic, Chest pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chest pain Gallbladder pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 21, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work

Free text: Had emergency surgery. Vaginal cuff dehisced after 9 weeks post op. Liver enzymes very elevated also

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — day 28, dose 1
MedDRA: Emergency care, Feeding disorder, Nausea, Surgery, Urticaria, Vaginal cuff dehiscence, Weight decreased, Wound evisceration — Feeling: Poor · Be unable to work

Free text: Nausea Lost 12 pounds Unable to eat Unexplained hives Was told do not get second vaccine. Had emergency surgery for vaginal cuff dehisced and bowel eviceration. Took IgG test two weeks after first vaccine and I have antibodies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 35, dose 1
MedDRA: Lymphadenopathy, Office visit, Urticaria — Feeling: Poor · Be unable to work

Free text: Hives Huge swollen lymph nodes under left vaccine side arm and breast. My gynecologist said that he did not want to send me for a mammogram because it showing abnormal nodes in the ultrasound. He wants me to wait a few more weeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 42, dose 1
MedDRA: Erythema, Nausea, Urticaria, Weight decreased — Feeling: Poor · Be unable to work

Free text: Hives and red arm Nausea Lost 20# unintentionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — 3 months, dose 1
MedDRA: Hepatic enzyme increased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Elevated liver enzymes and urq pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-27
Survey response — 6 months, dose 1
MedDRA: Abdominal pain upper — Feeling: Poor · Be unable to do your normal daily activities

Free text: Urq pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-26
Survey response — 12 months, dose 1
MedDRA: Fatigue, Headache, Neuropathy peripheral, Office visit — Feeling: Poor · 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: Neuropathy Headaches Fatigue · Healthcare visit (other): Neurologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 12 months, dose 1
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)
2022-01-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — day 14, dose 1

2021-02-09

Symptoms: Chest pain Gallbladder pain

Release 4 — day 21, dose 1

2021-02-16

Symptoms: Had emergency surgery. Vaginal cuff dehisced after 9 weeks post op. Liver enzymes very elevated also

Release 4 — day 28, dose 1

2021-02-23

Symptoms: Nausea Lost 12 pounds Unable to eat Unexplained hives Was told do not get second vaccine. Had emergency surgery for vaginal cuff dehisced and bowel eviceration. Took IgG test two weeks after first vaccine and I have antibodies

Release 5 — day 35, dose 1

2021-03-03

Symptoms: Hives Huge swollen lymph nodes under left vaccine side arm and breast. My gynecologist said that he did not want to send me for a mammogram because it showing abnormal nodes in the ultrasound. He wants me to wait a few more weeks

Release 5 — day 42, dose 1

2021-03-09

Symptoms: Hives and red arm Nausea Lost 20# unintentionally

Release 8 — 3 months, dose 1

2021-04-29

Symptoms: Elevated liver enzymes and urq pain

Release 9 — 6 months, dose 1

2021-07-27

Symptoms: Urq pain

Release 11 — 12 months, dose 1

2022-01-26

Symptoms: Neuropathy Headaches Fatigue

Healthcare visit (other): Neurologist

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	·	·	✓
SD	Abdominal pain upper	✓	·	✓
SD	Biliary colic	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Emergency care	✓	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Feeding disorder	✓	✓	✓
SD	Headache	·	·	✓
SD	Hepatic enzyme increased	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neuropathy peripheral	·	·	✓
SD	Office visit	✓	✓	✓
SD	Surgery	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vaginal cuff dehiscence	✓	✓	✓
SD	Weight decreased	✓	✓	✓
SD	Wound evisceration	✓	✓	✓

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