4XM-14737-77150

3 vaccinations 11 coded responses 38 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 207 / MD
Registered: 2021-03-29

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-29
Registered in v-safe
2021-03-29
Dose 1 — Moderna
2021-03-29
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen Lymph Node area under left arm pit on side where injection was administered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen lymph node under left arm pit on side that vaccine was administered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen lymph node under left arm pit on side that vaccine was administered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen lymph node under left arm pit (side that vaccine was administered)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Moderna
2021-04-26
Health check-in — day 0, dose 2
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling, Peripheral swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Severely swollen feet, ankles, lower leg area. The back and front of my knees are starting to feel like the may be getting ready to swell as well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling, Peripheral swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Severe swelling and hotness of the feet, ankles, lower leg, and knees.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling, Pain in extremity, Peripheral swelling — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swelling of feet, ankles and lower leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 7, dose 2
MedDRA: Joint swelling, Peripheral swelling — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild swelling of feet and ankles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Dose 3 — Moderna
Co-administered: Flu
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-24
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-29
Survey response — day 42, dose 3
MedDRA: COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, Pain, SARS-CoV-2 test positive — 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: Cough, fatigue, body ache, headache, sore throat, positive COVID test and diagnosis.

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Report sent to call center — day 42, 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)
2022-01-03
Call 1 — Left Voicemail
2022-01-03
Call successful
Participant prefers to complete VAERS report online
2022-02-16
Survey response — 3 months, dose 3
MedDRA: Disturbance in attention — Feeling: Fair

Free text: Lack of concentration

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — 6 months, dose 3
MedDRA: Diarrhoea, Disturbance in attention, Dyspnoea, Heart rate increased, Hot flush — 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

Free text: Shortness of breath, hot flashes, rapid heart beat, loose bowel, difficulty concentratingwanted to fill this out to help, and I think I'm misting a few symptoms, but thats all I can recall at this exact moment.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — 6 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)
2022-05-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-29	Moderna
2	2021-04-26	Moderna
3	2021-11-17	Moderna	Flu

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-02

Systemic reaction (other): Swollen Lymph Node area under left arm pit on side where injection was administered

2021-04-03

Systemic reaction (other): Swollen lymph node under left arm pit on side that vaccine was administered

2021-04-04

Systemic reaction (other): Swollen lymph node under left arm pit on side that vaccine was administered

Release 6 — day 7, dose 1

2021-04-05

Systemic reaction (other): Swollen lymph node under left arm pit (side that vaccine was administered)

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Severely swollen feet, ankles, lower leg area. The back and front of my knees are starting to feel like the may be getting ready to swell as well.

2021-05-01

Systemic reaction (other): Severe swelling and hotness of the feet, ankles, lower leg, and knees.

2021-05-02

Systemic reaction (other): Swelling of feet, ankles and lower leg

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): Mild swelling of feet and ankles

Release 10 — day 42, dose 3

2021-12-29

Symptoms: Cough, fatigue, body ache, headache, sore throat, positive COVID test and diagnosis.

Release 11 — 3 months, dose 3

2022-02-16

Symptoms: Lack of concentration

Release 11 — 6 months, dose 3

2022-05-18

Symptoms: Shortness of breath, hot flashes, rapid heart beat, loose bowel, difficulty concentratingwanted to fill this out to help, and I think I'm misting a few symptoms, but thats all I can recall at this exact moment.

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Hot flush	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Joint swelling	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓

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