5EY-24855-66974

3 vaccinations 11 coded responses 40 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 799 / TX
Registered: 2020-12-26

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Registered dependents

86N-13122-82746 Child or adolescent in my care · Female · 2021-11-10

EV7-23918-39807 Child or adolescent in my care · Male · 2021-11-10

Timeline

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

2020-12-24
Dose 1 — Moderna
2020-12-26
Registered in v-safe
2020-12-26
Survey response — days 1–6 daily, dose 1
MedDRA: Throat irritation — Feeling: Fair · Site: Pain, Redness · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-26
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2020-12-27
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2020-12-29
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tiredness

Free text: Swollen lymph axillary lymph node on arm of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Swollen and sore axillary lymph node on arm of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Survey response — day 7, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Swollen axillary lymph node on arm of injection, soreness to that lymph node

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-24
Dose 2 — Moderna
2021-01-24
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen lymph node to right axilla (same arm as injection)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: Swollen lymph node axilla of injected arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site reaction, Lymphadenopathy, Neuralgia — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Free text: Swollen axillary lymph node at arm of injection site, ulnar nerve pattern pain to forearm and hand since injection.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Swelling, Itching · Headache

Free text: Swollen lymph node

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Headache

Free text: Swollen lymph node

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-30
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · 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: Had a cold, got tested for covid, it was negative.

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Report sent to call center — 3 months, dose 3
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)
2022-01-31
Call 1 — Left Voicemail
2022-05-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-29
Survey response — 12 months, dose 3
MedDRA: COVID-19 — 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 · Outpatient clinic or urgent care clinic visit

Free text: Covid positive in early September 2022

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-24	Moderna
2	2021-01-24	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-26	priority 2/3
2020-12-27	priority 2/3
2022-01-30	Unsuccessful
2022-10-29	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-26

Systemic reaction (other): Scratchy throat

2020-12-29

Systemic reaction (other): Swollen lymph axillary lymph node on arm of injection

2020-12-30

Systemic reaction (other): Swollen and sore axillary lymph node on arm of injection

Release 1 — day 7, dose 1

2020-12-31

Systemic reaction (other): Swollen axillary lymph node on arm of injection, soreness to that lymph node

Release 2 — days 1–6 daily, dose 2

2021-01-26

Systemic reaction (other): Swollen lymph node to right axilla (same arm as injection)

2021-01-27

Systemic reaction (other): Swollen lymph node axilla of injected arm

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Swollen axillary lymph node at arm of injection site, ulnar nerve pattern pain to forearm and hand since injection.

2021-11-02

Systemic reaction (other): Swollen lymph node

2021-11-03

Systemic reaction (other): Swollen lymph node

Release 11 — 3 months, dose 3

2022-01-30

Symptoms: Had a cold, got tested for covid, it was negative.

Release 12 — 12 months, dose 3

2022-10-29

Symptoms: Covid positive in early September 2022

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	COVID-19	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Injection site reaction	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neuralgia	·	·	✓
SRO	Throat irritation	✓	✓	✓

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