XU7-28083-65003

3 vaccinations 13 coded responses 36 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 982 / WA
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Hypersomnia, Palpitations — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Conjunctivitis — Feeling: Fair · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Ocular hyperaemia, Sinus congestion — Feeling: Fair · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-24
Survey response — 7 day, dose 1
MedDRA: Lacrimation increased, Ocular hyperaemia, Sinus congestion, Sinus pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-31
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-14
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-15
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 do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — 7 day, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-03-07
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-03-28
Survey response — 42 day, dose 2
MedDRA: Inflammation, Neuralgia — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-16
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-08-15
Survey response — 6 month, dose 2
MedDRA: Ankylosing spondylitis, Arthralgia, Bladder disorder, Breast pain, Costochondritis, Fatigue, Pre-existing disease — Feeling: Fair · 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

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-15
Report sent to call center — 6 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-22
Call 1 — Left Voicemail
2022-01-19
Dose 3 — Moderna
2022-01-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-22
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-23
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-24
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Neck pain, Oedema peripheral, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-25
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site discolouration, Injection site erythema, Injection site rash — Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-26
Health check-in — 7 day, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-02-02
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2022-02-24
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2022-03-02
Survey response — 42 day, dose 3
MedDRA: Fatigue, Migraine — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-20
Survey response — 3 month, dose 3
MedDRA: Fatigue, Lymphadenopathy, Rash — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-14	Moderna
3	2022-01-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-15	Unsuccessful

Free text

Release 2

Systemic reaction (other): Slept all day today. Mild lightheaded a few times and mild heart palpitations twice

Systemic reaction (other): Woke up with conjunctivitis, probably unrelated but dont know

Systemic reaction (other): Red eyes and sinus congestion

Systemic reaction (other): Allergies? Red weepy eyes and sinus pain/congestion

Release 4

Systemic reaction (other): First evening heart palpitations but forgot to note, mild, about 2 hrs

Systemic reaction (other): The fatigue is crushing

Release 6

Symptoms: Inflammation and nerve pain

Release 9

Symptoms: Bladder issues possibly infection, increased Ankylosing Spondylitis pain and symptoms (fatigue, joint pain, Costochondritis), breast pain currently being diagnosed

Release 11

Systemic reaction (other): Armpit swelling and pain starting to feel better today

Systemic reaction (other): Armpit around and up to neck soreness & swelling better

Systemic reaction (other): Rash several inches below site and on other side of arm. It's red and light purple in a spot. Weird!

Symptoms: Migraine, fatigue

Symptoms: Still get swollen lymph nodes especially concerning is armpit - I had the orange sized one along with painful rash on arm. And fatigue.

Free-text releases are not linked to a specific 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	Ankylosing spondylitis	✓	·	✓
SD	Arthralgia	✓	·	✓
SD	Bladder disorder	✓	·	✓
SD	Breast pain	✓	·	✓
SD	Costochondritis	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Inflammation	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Migraine	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Rash	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Conjunctivitis	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Injection site discolouration	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site rash	·	·	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Swelling	·	·	✓

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