XWU-69275-87675

5 vaccinations 16 coded responses 43 check-ins 16 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 760 / TX
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Medical counselling, Swelling face — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-22
Health check-in — 7 day, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-02-03
Health check-in — 21 day, dose 1
Feeling: Fair

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, 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
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — 7 day, dose 2
Feeling: Good · Headache, Muscle or body aches, Diarrhea

Adult check-in
2021-02-24
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — 21 day, dose 2
MedDRA: Abdominal discomfort — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-10
Survey response — 28 day, dose 2
MedDRA: Gastric pH decreased, Stomatitis — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-17
Survey response — 35 day, dose 2
MedDRA: Gastrointestinal disorder — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-19
Call successful
Participant prefers to complete VAERS report online
2021-03-19
Call successful
Participant prefers to complete VAERS report online
2021-03-24
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-08-11
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-08-21
Dose 3 — Moderna
2021-11-20
Health check-in — 3 month, dose 3
Feeling: Fair

Adult check-in
2022-02-19
Health check-in — 6 month, dose 3
Feeling: Good

Adult check-in
2022-03-14
Dose 4 — Moderna
2022-04-14
Survey response — 28 day, dose 4
MedDRA: Lymphadenopathy, Odynophagia — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-25
Health check-in — 42 day, dose 4
Feeling: Fair

Adult check-in
2022-06-13
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2022-09-12
Survey response — 6 month, dose 4
MedDRA: Cellulitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11 · check-in answers available
2022-09-12
Report sent to call center — 6 month, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-09-13
Call 1 — Left Voicemail
2022-10-21
Dose 5 — Moderna
2022-10-21
Health check-in — 0 day, dose 5
Feeling: Good · Site: Pain · Headache, Joint pains, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-22
Survey response — days 1–6 daily, dose 5
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-25
Survey response — days 1–6 daily, dose 5
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-10-26
Survey response — days 1–6 daily, dose 5
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-10-27
Survey response — days 1–6 daily, dose 5
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2022-10-28
Health check-in — 7 day, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-04
Survey response — 14 day, dose 5
MedDRA: Headache — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-11-11
Survey response — 21 day, dose 5
MedDRA: Headache, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-11-11
Report sent to call center — 21 day, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-15
Call successful
Does not wish to fill out VAERS report
2022-11-15
Call successful
Does not wish to fill out VAERS report
2022-11-18
Health check-in — 28 day, dose 5
Feeling: Good

Adult check-in
2022-11-25
Survey response — 35 day, dose 5
MedDRA: Headache, Office visit, Pre-existing disease — 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
2022-11-25
Report sent to call center — 35 day, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-28
Call successful
Participant prefers to complete VAERS report online
2022-12-02
Health check-in — 42 day, dose 5
Feeling: Good

Adult check-in
2023-01-20
Health check-in — 3 month, dose 5
Feeling: Fair

Adult check-in
2023-04-21
Health check-in — 6 month, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-08-21	Moderna	No
4	2022-03-14	Moderna	No
5	2022-10-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-17	Successful 2021-03-19	Participant prefers to complete VAERS report online
2021-01-18	Successful 2021-03-19	Participant prefers to complete VAERS report online
2022-09-12	Successful 2022-11-15	Does not wish to fill out VAERS report
2022-11-11	Successful 2022-11-15	Does not wish to fill out VAERS report
2022-11-25	Successful 2022-11-28	Participant prefers to complete VAERS report online

Free text

Release 2

Systemic reaction (other): Very swollen lymph nodes under jaw that include neck area and swollen tissue around tmj joint

Healthcare visit (other): Spoke to family dr medical assistant. Waiting for dr to call me tonight.

Release 4

Systemic reaction (other): Swollen lymph nodes, sore throat

Systemic reaction (other): Stomach acidity

Systemic reaction (other): Acidic stomach

Release 5

Symptoms: Stomach acidity continues to get worse. Never had this problem until 4 days after 1st vaccine. 2nd vaccine made it worse.

Symptoms: Increased stomach acidity and multiple mouth sores.

Symptoms: Acidic stomach is getting worse. Never had this until a week after first Moderna shot. Started 2 - 14 day dose of prilosec. Also taking stomach acid medication as needed.

Release 11

Symptoms: The lymph nodes on the left side of my neck and under my chin swelled up so much I could only painfully swallow some liquid for 36 hours. This was on the same side of my body where i got the booster.

Release 12

Symptoms: Cellulitis

Systemic reaction (other): GERD

Symptoms: Daily headache is now around the clock.

Symptoms: Headaches are now round the clock

Healthcare visit (other): Going to see family practice dr on Monday at 11a

Symptoms: Headaches are more frequent and getting worsw

Healthcare visit (other): Family dr

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Cellulitis	·	·	✓
SD	Gastric pH decreased	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Odynophagia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Stomatitis	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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