6WG-21770-63047

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 493 / MI
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Fair · Fatigue or tiredness

Free text: Heart palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Left supraclavicular lymph node enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Supraclavicular lymph node enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Lymph node pain and swelling supraclavicular

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Supraclavicular lymph node enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · 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: Supraclavicular lymph node enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Survey response — day 21, dose 1
MedDRA: Herpes zoster, Lymphadenopathy, Ultrasound lymph nodes, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Enlarged supraclavicular lymph node, shingles · Healthcare visit (other): Ultrasound of lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Dose 2 — Moderna
2021-02-06
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — day 14, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat, mild.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Call successful
Participant prefers to complete VAERS report online
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Survey response — 12 months, dose 2
MedDRA: COVID-19, Infectious mononucleosis, Pregnancy, Tinnitus — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Pregnancy, covid 19, mono infection, tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-02-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-12	Successful	Participant prefers to complete VAERS report online
2021-01-13	Successful	Participant prefers to complete VAERS report online
2021-01-16	Successful	Participant prefers to complete VAERS report online
2021-02-01	Successful 2021-02-26	Participant prefers to complete VAERS report online
2022-02-13	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Systemic reaction (other): Heart palpitations

2021-01-12

Systemic reaction (other): Left supraclavicular lymph node enlarged

2021-01-13

Systemic reaction (other): Supraclavicular lymph node enlarged

2021-01-14

Systemic reaction (other): Lymph node pain and swelling supraclavicular

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Supraclavicular lymph node enlarged

Release 2 — day 7, dose 1

2021-01-16

Systemic reaction (other): Supraclavicular lymph node enlarged

Release 3 — day 21, dose 1

2021-02-01

Symptoms: Enlarged supraclavicular lymph node, shingles

Healthcare visit (other): Ultrasound of lymph nodes

Release 4 — day 14, dose 2

2021-02-20

Symptoms: Sore throat, mild.

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Pregnancy, covid 19, mono infection, tinnitus

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	Ultrasound lymph nodes	○	✓	○
HCVO	Unevaluable event	✓	·	✓
SD	COVID-19	·	·	✓
SD	Herpes zoster	✓	✓	✓
SD	Infectious mononucleosis	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Palpitations	✓	✓	✓

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