XYM-39577-80512

2 vaccinations 10 coded responses 19 check-ins 10 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 282 / NC
Registered: 2021-03-08

Relationship: Self
Race: Other
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-05
Dose 1 — Moderna
2021-03-08
Registered in v-safe
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, Itching

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, Pain — Feeling: Good · Site: Pain, Itching · Joint pains · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle twitching, Pruritus, Sensory disturbance — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Hypoaesthesia, Hypoaesthesia oral — Feeling: Fair · Joint pains · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-13
Survey response — 7 day, dose 1
MedDRA: Asthenia, Diarrhoea, Dizziness, Hyperhidrosis — Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-20
Survey response — 14 day, dose 1
MedDRA: Migraine, Muscle twitching, Pruritus — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-26
Health check-in — 21 day, dose 1
Feeling: Fair

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — 7 day, dose 2
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-22
Survey response — 21 day, dose 2
MedDRA: Photopsia — Feeling: Good · Be unable to work, 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: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-22
Report sent to call center — 21 day, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 35 day, dose 2
MedDRA: Office visit, Vitreous detachment — Feeling: Good · Be unable to work, 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: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-06
Report sent to call center — 35 day, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-13
Survey response — 42 day, dose 2
MedDRA: Arthralgia — Feeling: Poor · Be unable to work, 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
2021-05-13
Report sent to call center — 42 day, dose 2
Be unable to work · 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: Rash erythematous, Urticaria — Feeling: Poor · 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

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 work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-09-30
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-22	Unsuccessful
2021-05-06	Unsuccessful
2021-05-13	Unsuccessful
2021-07-03	Unsuccessful

Free text

Release 5

Systemic reaction (other): pain at injection site started several hours after injection was moderate and could not lay on that side, and it continued to last night but became very mild after that until now, but now it is starting to itch and may have a rash.

Systemic reaction (other): Left outer side of ankle, pain stepping down with pressure or twisting of ankle.

Systemic reaction (other): Spasms in lips and right side of face feels odd including around the right eye. Itch on back and leg.

Systemic reaction (other): Felt numbness on the left side of my face and jaw and lips quiver. My wrist are weak and in pain.

Systemic reaction (other): Dizzy, sweating and very weak while on the stool w/ diarrhea.

Release 6

Symptoms: Lip on left side of face quivering twitch and slight numbness on same side. Also a migraine and itching.

Release 7

Symptoms: Flashing in the outer corner of my eye continues

Release 8

Symptoms: vitreous starting to detach only started after second shot, no head or face trauma

Healthcare visit (other): Ophthalmologist

Symptoms: Ankle feels like I twisted it oh, but had no injury wrist and other ankle mildly in pain, right angle severely in pain as well as hip, knee and leg above-the-knee

Release 9

Symptoms: Red bumps and whelps

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	Migraine	✓	✓	✓
SD	Muscle twitching	✓	✓	✓
SD	Photopsia	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vitreous detachment	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓

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