XYF-84410-79722

2 vaccinations 18 coded responses 21 check-ins 18 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 145 / NY
Registered: 2021-03-04

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

2021-03-03
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Multiple sclerosis, Pre-existing disease — Feeling: Fair · 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
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · 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
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Balance disorder, Myalgia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-10
Survey response — 7 day, dose 1
MedDRA: Asthenia, Gait disturbance, Headache — Feeling: Good · 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
2021-03-19
Survey response — 14 day, dose 1
MedDRA: Arthralgia, Erythema, Joint swelling — Feeling: Fair · 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 — 21 day, dose 1
MedDRA: Arthropathy, Office visit — Feeling: Fair · 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
2021-03-24
Report sent to call center — 21 day, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — 0 day, dose 2
MedDRA: Dysphonia, Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Joint swelling, Peripheral swelling, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Nodule, Self-medication — Feeling: Fair · Site: Pain, Swelling · 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
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, 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
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain in extremity, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Site: Pain · 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
2021-04-09
Survey response — 7 day, dose 2
MedDRA: Diarrhoea, Neoplasm malignant, Rheumatoid arthritis — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea · 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 — 14 day, dose 2
MedDRA: Angiopathy, Computerised tomogram abnormal, Office visit, Peripheral swelling, Pre-existing disease, Supraventricular tachycardia, Ultrasound Doppler, Ultrasound Doppler abnormal — Feeling: Good · 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
2021-04-16
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

1 call case(s)
2021-04-23
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-02
Survey response — 28 day, dose 2
MedDRA: Cyst, Pain, Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-08
Survey response — 35 day, dose 2
MedDRA: Hospitalisation, Pain, Pre-existing disease, Rheumatoid arthritis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-08
Report sent to call center — 35 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-16
Survey response — 42 day, dose 2
MedDRA: Hospitalisation, Multiple sclerosis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-16
Report sent to call center — 42 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-03
Survey response — 3 month, dose 2
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Recurrent cancer, Rheumatoid arthritis, Rotator cuff syndrome — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-03
Report sent to call center — 3 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-10-02
Survey response — 6 month, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-10-02
Report sent to call center — 6 month, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-02	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-24	Unsuccessful
2021-04-16	Unsuccessful
2021-05-08	Unsuccessful
2021-05-16	Unsuccessful
2021-07-03	Unsuccessful
2021-10-02	Unsuccessful

Free text

Release 5

Systemic reaction (other): Symptoms may not related to the shot- have MS.

Systemic reaction (other): Slowly, symptoms are improving. Resting a lot.

Systemic reaction (other): Started prednisone, 60 mg. which has helped the joint and muscle pain. Balance is improved but still present when getting up to a standing position.

Systemic reaction (other): On 2nd day of prednisone step-down(50mg); feeling a little better but my headache is still behind the eyes (MS); still am having difficulty walking with the walker due to weakness

Symptoms: Shoulder pain, both but right worse than left.Right hand- joints became swollen, red and painful two days ago; Left hand, only 2 fingers & thumb. Today, not as red but swelling remains. Left ankle very painful, also swollen. Took pics, PCP Tues apt cut off by CDC

Release 6

Symptoms: The flare-up of my hand joints has continued. I saw my PCP Tuesday. Blood tests have been done and am waiting for results to try to determine what is causing this condition to continue after the prednisone step down.

Healthcare visit (other): In person office visit.

Systemic reaction (other): Feeling better-but still have the hoarseness in my voice and fatigue..

Systemic reaction (other): RA flare in right arm (swelling); hand joints swollen and red; right foot & ankle swollen. Shot was in right arm.

Systemic reaction (other): Arm muscle feels like its in a knot-very painful to touch as well internally. Hard to move. Joints same as yesterday. Been taking Tylenol, doesnt help much. Cold compress makes pain worse.

Systemic reaction (other): Feeling somewhat better. Joints in hands still very painful, especially in AM.

Release 7

Systemic reaction (other): RA flare in hands, esp. right hand joints, worse than yesterday; very painful. Ankle joints, both but left worse than right. Fatigue worse than yesterday. Symptoms improve as the day goes on.

Systemic reaction (other): Not sure the diarrhea is because of the shot. RA flare is still bad; symptoms same as yesterday. Good report from my cancer 3 month check up.

Symptoms: Swelling of feet has continued. Sent to vascular doctor; had ultrasound done. Diagnosed with chronic svt both legs plus malfunction of valves left leg. Ct of shoulder showed healing only one half of scapula. Concern still for cancer.

Healthcare visit (other): Office visit.

Release 8

Symptoms: Continuing to have more cysts come to surface.Swollen areas on right arm. Painful. Antibiotic seems to have had no effect. Plan to advise Dr. tomorrow.

Symptoms: In hospital. Rheumatoid arthritis attack-very painful.

Symptoms: Still in hospital- symptoms of MS flare are gradually getting better. Waiting for placement in rehabilitation facility. Staff shortages severe. Meds still not right. Food shortages seem to be corrected. Hospital still over capacity.

Release 9

Symptoms: Reoccurrence of cancer. Starting radiation July 12.RA still not under control.Treating MS with two infusions next week.Shoulder: rotator cuff injury about the same.

Healthcare visit (other): Regular Office Visit; CT Scan, X-ray - shoulder; steriod shots

Symptoms: Latest CTScan 8/13/21 showed cancer spread outside of radiated area treated successfully.Seeking second opinions as told not treatable.Have been advised NOT to take a boaster shot?What is the CDC recommendation in this type of case?

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	Angiopathy	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthropathy	✓	✓	✓
SD	Computerised tomogram abnormal	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Cyst	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Multiple sclerosis	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Recurrent cancer	○	✓	○
SD	Rheumatoid arthritis	✓	✓	✓
SD	Rotator cuff syndrome	✓	✓	✓
SD	Supraventricular tachycardia	✓	·	✓
SD	Ultrasound Doppler	○	✓	○
SD	Ultrasound Doppler abnormal	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dysphonia	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Multiple sclerosis	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neoplasm malignant	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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