XP6-56342-04604

3 vaccinations 5 coded responses 31 check-ins 5 free-text entries 5 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 117 / NY
Registered: 2021-01-07

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

YCB-20469-22344 Child or adolescent in my care · Male · 2021-11-26

Timeline

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
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
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Enlarged axillary lymph nodes about 1 week after injection. Lasted a few days then subsided.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Nausea

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · 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
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · 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 · Joint pains

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

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Survey response — day 7, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Enlarged axillary, clavicular and posterior cervical nodes. Very tender

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — 6 months, dose 2
MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Recent URI. Covid tested negative

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 2 — Left Voicemail
2021-11-05
Dose 3 — Moderna
2021-11-28
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-15
Call 1 — Left Voicemail
2022-02-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Survey response — 6 months, dose 3
MedDRA: COVID-19, Influenza, Neuralgia, Office visit — 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: Current flu Covid pos 12/28/22 with subsequent neuralgias to right foot. Seeing neurology for work up.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-09
Call 1 — Left Voicemail
2022-11-05
Survey response — 12 months, dose 3
MedDRA: Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Autonomic neuro dysfunction Anti mag demyelinating polyneuropathy (a cidp like disorder) Long covid

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-11-07
Call 3 — Left Voicemail
2022-11-07
Call 2 — Left Voicemail
2022-11-07
Call 1 — Left Voicemail
2022-11-07
Call successful
Participant prefers to complete VAERS report online
2022-11-07
Call successful
Participant prefers to complete VAERS report online
2022-11-07
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	priority 2/3
2021-01-09	priority 2/3
2021-08-05	Successful 2022-11-07	Participant prefers to complete VAERS report online
2022-05-06	Successful 2022-11-07	Participant prefers to complete VAERS report online
2022-11-05	Successful 2022-11-07	Participant prefers to complete VAERS report online

Free text

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Enlarged axillary lymph nodes about 1 week after injection. Lasted a few days then subsided.

Release 4 — day 7, dose 2

2021-02-11

Systemic reaction (other): Enlarged axillary, clavicular and posterior cervical nodes. Very tender

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: Recent URI. Covid tested negative

Release 11 — 6 months, dose 3

2022-05-06

Symptoms: Current flu Covid pos 12/28/22 with subsequent neuralgias to right foot. Seeing neurology for work up.

Release 12 — 12 months, dose 3

2022-11-05

Symptoms: Autonomic neuro dysfunction Anti mag demyelinating polyneuropathy (a cidp like disorder) Long covid

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	Influenza	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Neuralgia	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Upper respiratory tract infection	✓	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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