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XPY-25907-62080

2 vaccinations 5 coded responses 8 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
486 / MI
Registered
2021-02-03
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-08
    Dose 1 — Moderna
  2. 2021-02-01
    Dose 2 — Moderna
  3. 2021-02-03
    Registered in v-safe
  4. 2021-02-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymph node pain, Lymphadenopathy, Rash, Syncope, Tenderness — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Syncope 20 hrs following vaccine #2. Tender/swollen glands. Rash on entire upper arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-03
    Survey response — day 21, dose 1
    MedDRA: Lymphadenopathy, Rash, Syncope — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Syncope, rash and tender/swollen glands after second vaccine on 2/1/21
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site
    Free text: Swollen glands
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling, Itching · Rash, not including the immediate area around the injection site
    Adult check-in
  8. 2021-02-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Rash, not including the immediate area around the injection site
    Adult check-in
  9. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-08-02
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Fatigue, Muscle spasms, Myalgia, Postmenopausal haemorrhage — 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: Post-menopausal vaginal bleeding and cramping (Biopsy was Normal). Tiredness. Aching in joints/muscles, especially in lower extremities. Onset of all symptoms was within 1 month of Covid vaccine.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  11. 2021-08-02
    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)
  12. 2021-08-13
  13. 2022-02-02
    Survey response — 12 months, dose 2
    MedDRA: Arthralgia, Pain in extremity, Postmenopausal haemorrhage, Surgery, Uterine dilation and curettage — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Post menopausal vaginal bleeding. Onset 2-3 weeks after vaccine. Two biopsies negative. Resolved after 6 months with D & C. Pain in bilateral legs, ankles, feet, toes. Onset 2-4 weeks after vaccine. Subsided 8 months after vaccine · Healthcare visit (other): Surgery
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-02-02
    Report sent to call center — 12 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
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  15. 2022-02-03
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-01-08Moderna
22021-02-01Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-08-02 Successful Participant prefers to complete VAERS report online
2022-02-02 Successful
2022-02-03
Participant prefers to complete VAERS report online

Free text

Release 3 — day 21, dose 1

2021-02-03

Symptoms: Syncope, rash and tender/swollen glands after second vaccine on 2/1/21

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Syncope 20 hrs following vaccine #2. Tender/swollen glands. Rash on entire upper arm

2021-02-04

Systemic reaction (other): Swollen glands

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: Post-menopausal vaginal bleeding and cramping (Biopsy was Normal). Tiredness. Aching in joints/muscles, especially in lower extremities. Onset of all symptoms was within 1 month of Covid vaccine.

Release 11 — 12 months, dose 2

2022-02-02

Symptoms: Post menopausal vaginal bleeding. Onset 2-3 weeks after vaccine. Two biopsies negative. Resolved after 6 months with D & C. Pain in bilateral legs, ankles, feet, toes. Onset 2-4 weeks after vaccine. Subsided 8 months after vaccine
Healthcare visit (other): Surgery

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

FieldPreferred term2021-092023-042024-11
HCVOSurgery · · ✓
SDArthralgia ✓ · ✓
SDFatigue ✓ · ✓
SDLymphadenopathy ✓ ✓ ✓
SDMuscle spasms ✓ · ✓
SDMyalgia ✓ · ✓
SDPain in extremity · · ✓
SDPostmenopausal haemorrhage ✓ · ✓
SDRash ✓ ✓ ✓
SDSyncope ✓ ✓ ✓
SDUterine dilation and curettage · · ✓
SROLymph node pain ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SRORash ✓ ✓ ✓
SROSyncope ✓ ✓ ✓
SROTenderness ○ ✓ ○

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