XUV-16003-85658

3 vaccinations 16 coded responses 35 check-ins 16 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 103 / NY
Registered: 2021-01-21

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-21
Health check-in — 0 day, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Eye irritation, Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-22
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-11
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dysphonia, Nasal congestion — Feeling: Poor · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation, Nasal congestion — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dysphonia, Nasal congestion — Feeling: Fair · Site: Swelling · Fever · Joint pains, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Swelling, Itching · Headache, Muscle or body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Headache, Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-24
Survey response — 7 day, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-03
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — 21 day, dose 2
MedDRA: Oral herpes, Oropharyngeal pain — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-19
Survey response — 28 day, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-24
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-01
Call 1 — Left Voicemail
2021-04-02
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — 3 month, dose 2
MedDRA: Lymphadenopathy, Oropharyngeal pain, Unevaluable event — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-20
Report sent to call center — 3 month, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-18
Survey response — 6 month, dose 2
MedDRA: Lymphadenopathy, Office visit, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-18
Report sent to call center — 6 month, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Call 1 — Left Voicemail
2021-09-18
Dose 3 — Moderna
2021-09-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-09-22
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling cold, Hyperhidrosis — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain

MedDRA releases: 2024-11 · check-in answers available
2021-09-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-09-25
Health check-in — 7 day, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-02
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-10-09
Survey response — 21 day, dose 3
MedDRA: Feeling of body temperature change — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-10-16
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2021-10-25
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-10-30
Survey response — 42 day, dose 3
MedDRA: Cough, Fatigue, Paranasal sinus discomfort, Respiratory tract congestion — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-03-19
Survey response — 6 month, dose 3
MedDRA: Condition aggravated, Lymphadenopathy, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-03-19
Report sent to call center — 6 month, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-22
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-17	Moderna
3	2021-09-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-22	Unsuccessful
2021-05-20	Unsuccessful
2021-08-18	Unsuccessful
2022-03-19	Successful 2022-03-22	Participant prefers to complete VAERS report online

Free text

Release 2

Systemic reaction (other): Burning eyes

Healthcare visit (other): Called my GP to see what I could take to help Sx's. He didn't call back yet

Release 4

Systemic reaction (other): Stuffy nose, hoarse voice

Systemic reaction (other): Stuffy nose and eyes burning

Systemic reaction (other): Stuffy nose & hoarse voice

Systemic reaction (other): My lymphnodes in my armpit & neck are very swollen. Armpit started 2 days ago my neck I noticed this morning.

Systemic reaction (other): Even more swollen lymphnodes in armpit, shoulder, collar bone & neck that are visible

Systemic reaction (other): Incredibly huge lymphnodes in my neck and arm

Systemic reaction (other): Lymphnodes still very swollen

Release 5

Symptoms: I had a sore throat and developed a fever blister over the week (i have herpes B i believe) there weren't any other factors im aware of other then my immune response to the vac that could cause this

Release 6

Symptoms: Still have enlarged lymphnodes in my neck

Release 8

Symptoms: I currently have a sore throat, swollen glands, and lymphnodes- possibly from allergies

Healthcare visit (other): Have an appt with my GP soon

Release 9

Symptoms: I have had swollen glands/lymphnodes during a sinus infection

Healthcare visit (other): doctors office

Systemic reaction (other): sweating to freezing

Release 10

Symptoms: I continue to feel super cold and then super hot

Symptoms: fatigue cough congestion sinus pressure - not from the vaccine

Release 11

Symptoms: swollen lymphnodes, reactivated Epstein Barr without being around anyone

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
HCVO	Office visit	✓	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling of body temperature change	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Oral herpes	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	✓	·	✓
SRO	Dysphonia	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Feeling cold	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓

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