XVL-17579-24832

4 vaccinations 16 coded responses 43 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 786 / TX
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Survey response — 0 day, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Nausea

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Adnexa uteri pain, Dysmenorrhoea, Feeling abnormal, Night sweats — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — 7 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Survey response — 14 day, dose 2
MedDRA: Breast pain, Burning sensation, Flank pain, Neuralgia — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-26
Survey response — 21 day, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-02
Survey response — 28 day, dose 2
MedDRA: Fatigue, Malaise — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-13
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-05
Survey response — 6 month, dose 2
MedDRA: Injection site pain, Tinnitus — Feeling: Good

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-10-28
Dose 3 — Moderna
2021-10-28
Survey response — 0 day, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

MedDRA releases: 2024-11 · check-in answers available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Dysmenorrhoea, Menstruation irregular — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain

MedDRA releases: 2024-11 · check-in answers available
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-04
Health check-in — 7 day, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-11
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-18
Survey response — 21 day, dose 3
MedDRA: Chest discomfort, Dyspnoea, Middle insomnia, Night sweats — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-11-25
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — 35 day, dose 3
MedDRA: Headache, Nausea, Tinnitus, Vertigo — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-09
Survey response — 42 day, dose 3
MedDRA: Nausea, Office visit, Tinnitus, Vertigo — 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

MedDRA releases: 2024-11 · check-in answers available
2021-12-09
Report sent to call center — 42 day, 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)
2021-12-10
Call successful
Participant prefers to complete VAERS report online
2022-01-29
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-04-30
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-10-07
Dose 4 — Moderna
Co-administered: Flu
2022-10-29
Health check-in — 12 month, dose 3
Feeling: Good

Adult check-in
2022-10-29
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-11-04
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-11-11
Health check-in — 35 day, dose 4
Feeling: Good

Adult check-in
2022-11-18
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2023-01-07
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2023-04-09
Survey response — 6 month, dose 4
MedDRA: Infectious mononucleosis — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2023-04-09
Report sent to call center — 6 month, dose 4
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)
2023-04-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna
3	2021-10-28	Moderna	No
4	2022-10-07	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-12-09	Successful 2021-12-10	Participant prefers to complete VAERS report online
2023-04-09	Unsuccessful

Free text

Release 3

Systemic reaction (other): Sore arm

Release 5

Systemic reaction (other): Night sweats, foggy brain, ovarian pain more targeted than menstrual cramps

Systemic reaction (other): Night sweats

Symptoms: I have no idea if this is related to the vaccine, but I've had nerve pain where it felt like I had a burning rash on my non-shot arm (nothing visually there) and pain as if I was being impaled on my side/breast area (again, no visual symptoms).

Release 6

Symptoms: Extreme fatigue.

Symptoms: Still quite tired and general malaise.

Release 9

Symptoms: The location where I received my shot will occasionally hurt. It's such an odd sensation. Also, I have lots of ringing in my ears - no idea if that is related.

Release 10

Systemic reaction (other): Lack of appetite

Systemic reaction (other): Menstrual cycle arrived early, very painful

Symptoms: Night sweats and waking feeling like I can't breathe - heaviness in chest.

Symptoms: Intense tinnitus, vertigo, nausea, headache

Symptoms: Extreme vertigo, nausea, tinnitus - I don't know that any of this is related to my Covid vaccine (I would doubt it) but reporting it anyway

Healthcare visit (other): Primary care visit, testing at a balance clinic, upcoming ENT appointment

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	·	·	✓
SD	Breast pain	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Flank pain	✓	✓	✓
SD	Headache	·	·	✓
SD	Infectious mononucleosis	·	·	✓
SD	Injection site pain	✓	·	✓
SD	Malaise	✓	✓	✓
SD	Middle insomnia	·	·	✓
SD	Nausea	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Night sweats	·	·	✓
SD	Tinnitus	✓	·	✓
SD	Vertigo	·	·	✓
SRO	Adnexa uteri pain	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Dysmenorrhoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Menstruation irregular	·	·	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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