5P3-32099-51597

2 vaccinations 12 coded responses 13 check-ins 12 free-text entries 4 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 201 / VA
Registered: 2021-01-25

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2020-12-24
Dose 1 — Moderna
2021-01-22
Dose 2 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Nodule, Swelling — Feeling: Poor · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Free text: Nodule swelling cloes to left side neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Nodule — Feeling: Poor · Site: Pain, Swelling · Joint pains, Fatigue or tiredness · Be unable to work, 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: Nodule and lump swelling at clavicle and pain. Cloes to the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Nodule, Pain, Swelling — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Left clavicle nodule pain and swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain, Swelling — Feeling: Poor · Site: Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Nodule pain and swelling at left side Neck clavicle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Swelling · Joint pains · Be unable to do your normal daily activities

Free text: Nodule at left side of clavicle and neck swelling and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Lymphadenopathy — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nodule cloes to left clavicle swelling and episode of breathing discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 21, dose 2
MedDRA: Dyspnoea, Fatigue, Nodule — Feeling: Poor · Be unable to do your normal daily activities

Free text: Shortness of breathing and fatigue,noticable nodule on left side neck and clavicle . Primary doctor is aware, and I been following up with me. Diagnostic test are order.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 28, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Be unable to do your normal daily activities

Free text: CT Results positive of Nodule inflammation after 3 weeks .It reflected clavicle noudel swelling cause by the 2 dose of vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 35, dose 2
MedDRA: Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Neck pain and nodule still large on left clavicle region.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Headache, Neck pain, Nodule, Pain — Feeling: Poor · 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: Neck pain is radiating to head with headaches at night time noudle are still noticable on left side of clavicle .and starting to feel chest discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-06-08
Call 1 — Left Voicemail
2021-07-23
Survey response — 6 months, dose 2
MedDRA: Neuralgia, Unevaluable event — 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: Nerve pain in bilateral-arm · Healthcare visit (other): Pain med

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — 6 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

1 call case(s)
2021-07-29
Call 1 — Left Voicemail
2022-01-24
Survey response — 12 months, dose 2
MedDRA: Neck pain, Photophobia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: La side neck pain an photophobia

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-25
Call 1 — Left Voicemail
2022-01-26
Call 2 — Left Voicemail
2022-01-26
Callback requested for
02:30PM ET
2022-01-26
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-24	Moderna
2	2021-01-22	Moderna

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-25

Systemic reaction (other): Nodule swelling cloes to left side neck

2021-01-26

Systemic reaction (other): Nodule and lump swelling at clavicle and pain. Cloes to the injection site.

2021-01-27

Systemic reaction (other): Left clavicle nodule pain and swelling

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Nodule pain and swelling at left side Neck clavicle

Release 3 — day 7, dose 2

2021-01-29

Systemic reaction (other): Nodule at left side of clavicle and neck swelling and pain

Release 3 — day 14, dose 2

2021-02-05

Symptoms: Nodule cloes to left clavicle swelling and episode of breathing discomfort

Release 4 — day 21, dose 2

2021-02-12

Symptoms: Shortness of breathing and fatigue,noticable nodule on left side neck and clavicle . Primary doctor is aware, and I been following up with me. Diagnostic test are order.

Release 4 — day 28, dose 2

2021-02-19

Symptoms: CT Results positive of Nodule inflammation after 3 weeks .It reflected clavicle noudel swelling cause by the 2 dose of vaccine.

Release 4 — day 35, dose 2

2021-02-26

Symptoms: Neck pain and nodule still large on left clavicle region.

Release 5 — day 42, dose 2

2021-03-05

Symptoms: Neck pain is radiating to head with headaches at night time noudle are still noticable on left side of clavicle .and starting to feel chest discomfort.

Release 9 — 6 months, dose 2

2021-07-23

Symptoms: Nerve pain in bilateral-arm

Healthcare visit (other): Pain med

Release 11 — 12 months, dose 2

2022-01-24

Symptoms: La side neck pain an photophobia

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	Unevaluable event	✓	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Neuralgia	✓	·	✓
SD	Nodule	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Photophobia	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Swelling	✓	✓	✓

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