UME-67481-19802

3 vaccinations 11 coded responses 21 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 921 / CA
Registered: 2021-05-01

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

2021-04-03
Dose 1 — Moderna
2021-05-01
Registered in v-safe
2021-05-01
Dose 2 — Moderna
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Swollen supraclavicular lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Free text: Supraclavicular lymph node swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Supraclavicular lymph nodes swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Breast feeding — Feeling: Good · Muscle or body aches, Diarrhea

Free text: Supraclavicular lymph nodes swollen; lactation reduction (currently breastfeeding 11 months)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Muscle or body aches

Free text: Supraclavicular lymph nodes swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-31
Survey response — 3 months, dose 2
MedDRA: Gastroenteritis viral — Feeling: Good · Be unable to do your normal daily activities

Free text: 24 hour stomach flu

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-30
Survey response — 6 months, dose 2
MedDRA: Abortion spontaneous — Feeling: Fair · Be unable to work or attend school

Free text: Pregnancy & miscarriage at 10 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — 12 months, dose 2
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Runny nose, cough, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Dose 3 — Moderna
2022-10-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-10-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-10-30
Survey response — day 42, dose 3
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Survey response — 3 months, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2023-03-21
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous, Dizziness, In vitro fertilisation — 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

MedDRA releases: 2024-11
2023-03-21
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-22
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Moderna
2	2021-05-01	Moderna
3	2022-09-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-03-21	Successful 2023-03-22	Does not wish to fill out VAERS report

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-02

Systemic reaction (other): Swollen supraclavicular lymph nodes

2021-05-03

Systemic reaction (other): Supraclavicular lymph node swelling

2021-05-04

Systemic reaction (other): Supraclavicular lymph nodes swollen

2021-05-05

Systemic reaction (other): Supraclavicular lymph nodes swollen; lactation reduction (currently breastfeeding 11 months)

2021-05-06

Systemic reaction (other): Supraclavicular lymph nodes swollen

Release 9 — 3 months, dose 2

2021-07-31

Symptoms: 24 hour stomach flu

Release 10 — 6 months, dose 2

2021-10-30

Symptoms: Pregnancy & miscarriage at 10 weeks

Release 11 — 12 months, dose 2

2022-05-01

Symptoms: Runny nose, cough, sore throat

Release 12 — day 42, dose 3

2022-10-30

Symptoms: Congestion, runny nose

Release 12 — 3 months, dose 3

2022-12-18

Symptoms: Congestion

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	Abortion spontaneous	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Gastroenteritis viral	✓	·	✓
SD	In vitro fertilisation	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Breast feeding	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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