XVN-33242-16352

2 vaccinations 15 coded responses 21 check-ins 15 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 491 / MI
Registered: 2021-03-22

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

2021-03-17
Dose 1 — Moderna
2021-03-22
Registered in v-safe
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Myalgia, Nausea, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Headache, 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
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Headache, Lymph node pain, Lymphadenopathy, Neck pain, Pain in extremity — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-24
Survey response — 7 day, dose 1
MedDRA: Headache, Lymphadenopathy, Neck pain, Pain in extremity, Pain in jaw — Feeling: Fair · Headache · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-31
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-04-07
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Survey response — 0 day, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold, Malaise, Pyrexia — 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Feeding disorder, Illness, Nausea, Swelling — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Lymphadenopathy, Neck pain, Pain in jaw — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Lymphadenopathy, Pain in jaw — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Lymphadenopathy, Neck pain, Pain in extremity, Pain in jaw — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Neck pain, Pain in jaw — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-21
Survey response — 7 day, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-28
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-05-05
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-12
Survey response — 28 day, dose 2
MedDRA: Headache, Lymphadenopathy — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-19
Survey response — 35 day, dose 2
MedDRA: Headache, Lymphadenopathy, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-26
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-13
Survey response — 6 month, dose 2
MedDRA: Asthenia, Fatigue, Swelling — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-14
Survey response — 12 month, dose 2
MedDRA: Asthenia, Fatigue, Office visit — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-04-14
Report sent to call center — 12 month, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-27
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-04-14	Unsuccessful

Free text

Release 6

Systemic reaction (other): Had fever 2nd day, muscle aches,dizzy,sick to stomach ,felt like throwing up.

Systemic reaction (other): My 4th day my lymph node right side of neck and shoulder really swollen. Still swollen. Makes head and neck and right arm and shoulder very sore. Lymph node still swollen and same soreness.

Systemic reaction (other): My right lymph node in my neck still swollen. Makes me have a headache and neck sore and jaw sore and right arm.

Release 7

Systemic reaction (other): Arm sore

Systemic reaction (other): Had fever than went sub normal 96.8 degrees. So cold .took 2 hour hot bath to bring temp up. I should not get this sick from a vaccine . Very very bad

Systemic reaction (other): My right neck swelling up .This morning so sick. So nausea couldnt eat breakfast. At 1 pm was able to eat some lunch. Starting to feel some better as of 3:30 pm. Should not get so sick from vaccine. Dont want to take any more if does this to me. Others I know has done this to the women also.

Systemic reaction (other): Right side of neck- lymph node. Jaw sore from it. Neck sore from it and head sore from it.

Systemic reaction (other): Right side of neck swollen-lymph nodes. Makes my head and jaw and arm hurt.

Systemic reaction (other): Right side of neck lymph node . Jaw hurts neck so sore , headache. Right arm sore.

Systemic reaction (other): Right side of neck, jaw head hurt.

Systemic reaction (other): Right neck , head, right arm from lymph node.

Release 8

Symptoms: Right side of neck the lymph node swollen again.have headache from it.

Symptoms: Right side of neck lymph node still swollen. Makes neck and head sore.

Release 10

Symptoms: Weakness, tired. Can't get all my strength back yet. Neck right side still swells.

Release 11

Symptoms: Tired, low energy,

Healthcare visit (other): My doctor

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	Asthenia	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Swelling	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeding disorder	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Illness	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Swelling	✓	✓	✓

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