XW6-19167-46432

2 vaccinations 12 coded responses 17 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 264 / WV
Registered: 2021-09-20

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

2021-09-15
Dose 1 — Moderna
2021-09-20
Registered in v-safe
2021-09-20
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-09-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-09-22
Health check-in — 7 day, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-29
Survey response — 14 day, dose 1
MedDRA: Headache, Injection site erythema, Injection site reaction, Injection site warmth, Urticaria — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-10-06
Health check-in — 21 day, dose 1
Feeling: Fair

Adult check-in
2021-10-13
Dose 2 — Moderna
2021-10-13
Survey response — 0 day, dose 2
MedDRA: Flushing — Feeling: Fair · Fever · Headache, Muscle or body aches

MedDRA releases: 2024-11 · check-in answers available
2021-10-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-18
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Flushing — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-19
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-20
Health check-in — 7 day, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-27
Survey response — 14 day, dose 2
MedDRA: Abscess, Flank pain, Jaw disorder, Lymph node pain, Nausea, Pharyngeal disorder, Pyrexia, Unevaluable event — Feeling: Poor · 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
2021-10-27
Report sent to call center — 14 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-01
Call 2 — Left Voicemail
2021-11-11
Survey response — 28 day, dose 2
MedDRA: Fatigue, Pain, Taste disorder, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-17
Survey response — 35 day, dose 2
MedDRA: Taste disorder, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-12
Survey response — 3 month, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-14
Survey response — 6 month, dose 2
MedDRA: Arthralgia, Headache, Muscle spasms, Respiratory disorder — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-10-13
Survey response — 12 month, dose 2
MedDRA: Adverse drug reaction, Dyspnoea, Office visit — Feeling: Poor · 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
2022-10-13
Report sent to call center — 12 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-14
Call 1 — Left Voicemail
2022-10-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-15	Moderna	No
2	2021-10-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-27	Unsuccessful
2022-10-13	Unsuccessful

Free text

Release 9

Systemic reaction (other): Lymph nodes painful on left under arm and chest

Systemic reaction (other): Lymph node pain

Symptoms: Headaches, Shot area has turned red and has a welp and warm to touch

Release 10

Systemic reaction (other): Feeling Flushed

Systemic reaction (other): Feeling flushed and weak

Systemic reaction (other): Really tired and Sleepy

Symptoms: Severe sudden abscess that spread to my temple neck throat jaw problems with hearing fever severe pain nausea all on the right side I had the injection in my right arm lymph nodes in my arm and neck painful

Symptoms: Tired ache all over, had the mouth and throat problem, i have noticed my taste buds are not the same

Symptoms: Throat is still irritated even after taking an antibiotic, i have noticed my taste buds are off, nothing tastes like it should

Symptoms: I did this at one time already and I don't know if it went through said it expired while I was trying to type it out and fit in the 250 words in your short time

Release 11

Symptoms: Lymph node spasms severe joint pain headaches sometimes breathing problems

Release 12

Symptoms: Shortness of breath major sensitivities to medications

Healthcare visit (other): Ophthalmology

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	Abscess	·	·	✓
SD	Adverse drug reaction	·	·	✓
SD	Arthralgia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Flank pain	·	·	✓
SD	Headache	·	·	✓
SD	Injection site erythema	·	·	✓
SD	Injection site reaction	·	·	✓
SD	Injection site warmth	·	·	✓
SD	Jaw disorder	·	·	✓
SD	Lymph node pain	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pharyngeal disorder	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Taste disorder	·	·	✓
SD	Throat irritation	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urticaria	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Flushing	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Somnolence	·	·	✓

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