XYT-55469-77614

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 760 / TX
Registered: 2021-02-01

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

2021-02-01
Registered in v-safe
2021-02-01
Dose 1 — Moderna
2021-02-01
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain, Itching · Headache

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

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-08
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — 14 day, dose 1
MedDRA: Cough, Nausea, Oropharyngeal pain — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-22
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site nodule, Injection site pain, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-08
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — 35 day, dose 2
MedDRA: Vein collapse — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-12
Survey response — 42 day, dose 2
MedDRA: Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-12
Report sent to call center — 42 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Survey response — 3 month, dose 2
MedDRA: Contusion, Hyperaesthesia, Pain, Vein disorder — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-08-30
Survey response — 6 month, dose 2
MedDRA: Cough, Dyspnoea, Headache, Lymph node pain, Middle ear effusion, Muscle spasms, Nasal congestion, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, Sneezing, Upper-airway cough syndrome — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-11-07
Call 1 — Left Voicemail
2022-03-03
Survey response — 12 month, dose 2
MedDRA: Cough, Fatigue, Muscle fatigue, Pain — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-12	Unsuccessful

Free text

Release 3

Systemic reaction (other): The pain from the injection is MUCH better today. Yesterday my arm was hard to move it hurt so much.

Release 4

Symptoms: Some nausea, sore throat and intermittent cough

Systemic reaction (other): Somewhat sore throat

Release 5

Systemic reaction (other): A large nodule about 2 wide at the injection site. Yesterday I had more swelling around the injection site but didnt realize it until after I submitted the survey. It was too tender to touch.

Release 6

Symptoms: I have had blood taken twice in the last two weeks and has been trickling into the vial very slowly. Also the veins collapsed easily. I had something similar happen a week after my first shot and didnt think much of it, but it has been worsening.

Release 7

Symptoms: My veins kept collapsing when they were trying to take blood in the hospital. Even when they got a vein it would give out easily.

Release 8

Symptoms: Increased all over body pain, more skin sensitivity and bruising, and it was extra difficult to have blood labs drawn despite making an extra effort to be hydrated. Most of my veins were flat.

Release 9

Symptoms: Sore throat and glands, coughing, post nasal drip, some difficulty breathing, body aches and muscle cramping, sneezing, dripping nose, headaches, nasal and head congestion with liquid in my ears.

Release 11

Symptoms: I am experiencing more fatigue, a scratchy cough and increased all over body pain and muscle fatigue.

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
SD	Contusion	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	·	✓
SD	Hyperaesthesia	✓	✓	✓
SD	Lymph node pain	✓	·	✓
SD	Middle ear effusion	✓	·	✓
SD	Muscle fatigue	·	·	✓
SD	Muscle spasms	✓	·	✓
SD	Nasal congestion	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Respiratory tract congestion	✓	·	✓
SD	Rhinorrhoea	✓	·	✓
SD	Sneezing	✓	·	✓
SD	Unevaluable event	✓	✓	✓
SD	Upper-airway cough syndrome	✓	·	✓
SD	Vein collapse	✓	✓	✓
SD	Vein disorder	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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