XW7-29753-15236

3 vaccinations 15 coded responses 29 check-ins 15 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 235 / VA
Registered: 2021-02-17

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Moderna
2021-02-17
Survey response — 0 day, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Survey response — 7 day, dose 1
MedDRA: Axillary pain, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-03
Survey response — 14 day, dose 1
MedDRA: Axillary pain, Headache, Lymphadenopathy — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-12
Health check-in — 21 day, dose 1
Feeling: Fair

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-17
Survey response — 0 day, dose 2
MedDRA: Head discomfort, Paraesthesia — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Abdominal pain

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good · Site: Pain · Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Head discomfort — Feeling: Good · Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-24
Health check-in — 7 day, dose 2
Feeling: Fair · Fever · Headache

Adult check-in
2021-03-31
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — 28 day, dose 2
MedDRA: Muscle twitching — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-21
Survey response — 35 day, dose 2
MedDRA: Tic — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-28
Survey response — 42 day, dose 2
MedDRA: Muscle spasms — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-16
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-15
Survey response — 6 month, dose 2
MedDRA: Cardiomegaly, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-09-15
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)
2021-09-17
Call 2 — Left Voicemail
2022-03-19
Survey response — 12 month, dose 2
MedDRA: Office visit, Osteoarthritis — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-03-19
Report sent to call center — 12 month, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-23
Call successful
Not applicable - Accidental Reporting
2022-03-23
Call successful
Not applicable - Accidental Reporting
2022-04-02
Dose 3 — Moderna
2022-04-29
Survey response — 21 day, dose 3
MedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11 · check-in answers available
2022-04-30
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2022-05-08
Survey response — 35 day, dose 3
MedDRA: Cough, Office visit, Upper respiratory tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-05-08
Report sent to call center — 35 day, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-09
Call 1 — Left Voicemail
2022-05-09
Call 1 — Left Voicemail
2022-05-09
Call 1 — Left Voicemail
2022-05-14
Health check-in — 42 day, dose 3
Feeling: Fair

Adult check-in
2022-07-02
Survey response — 3 month, dose 3
MedDRA: Arthralgia, Joint swelling, Osteoarthritis, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-10-01
Survey response — 6 month, dose 3
MedDRA: Formication, Mass, Neurological symptom, Tension headache — 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	2021-02-17	Moderna
2	2021-03-17	Moderna
3	2022-04-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-15	Successful 2022-03-23	Not applicable - Accidental Reporting
2022-03-19	Successful 2022-03-23	Not applicable - Accidental Reporting
2022-05-08	Unsuccessful

Free text

Release 4

Systemic reaction (other): Head feels cloggy at times

Systemic reaction (other): Mild pain & little swelling in armpit area

Release 5

Symptoms: Headach on right side of head and underarm has pain in isolated spot & spot a little swelling ...feels like a swollen lympnodes??? Pain & swelling mild now...going away

Systemic reaction (other): Head Tingling & pressure

Release 6

Systemic reaction (other): Underarm mild pain

Systemic reaction (other): Head Pressure

Release 7

Symptoms: Face twitch on right side by cheek bones. Multiple times a day

Symptoms: Facial tics on right side..may br stress???

Release 8

Symptoms: Muscles fluttering

Release 9

Symptoms: Left side of heart enlarged

Healthcare visit (other): Primary

Release 11

Symptoms: Osteoarthritis in knees

Healthcare visit (other): doctor visit and xrays

Symptoms: Upper respiratory infection

Symptoms: Coughing back from upper respiratory infection

Healthcare visit (other): primary Care

Release 12

Symptoms: Knee flare up from Osteoarthritis. Knee pain and swelling

Symptoms: Small lump at mid right, top..right side of head tightening up..crawling, seizing feeling

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	Arthralgia	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Cardiomegaly	·	·	✓
SD	Cough	·	·	✓
SD	Formication	·	·	✓
SD	Headache	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Mass	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Muscle twitching	✓	✓	✓
SD	Neurological symptom	·	·	✓
SD	Osteoarthritis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Tension headache	·	·	✓
SD	Tic	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓

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