XYX-29716-91527

2 vaccinations 13 coded responses 25 check-ins 13 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 782 / TX
Registered: 2021-03-04

Relationship: Self
Race: White
Ethnicity: 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
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling · Joint pains, Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Muscle or body aches, Diarrhea

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Good · Chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Feeling abnormal, Pain, Pain in extremity — Feeling: Poor · Fever · Chills, 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
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Body temperature normal, Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-10
Health check-in — 7 day, dose 1
Feeling: Fair · Chills, Headache, Muscle or body aches, Nausea

Adult check-in
2021-03-17
Survey response — 14 day, dose 1
MedDRA: Headache, Insomnia, Medical counselling, Myalgia, Pain, Telemedicine — Feeling: Poor · 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
2021-03-17
Report sent to call center — 14 day, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — 21 day, dose 1
MedDRA: Insomnia, Muscle discomfort, Self-medication — 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
2021-03-24
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)
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — 0 day, dose 2
MedDRA: Feeling cold — Feeling: Good · Site: Pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Good · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair · Chills, 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
2021-04-07
Survey response — 7 day, dose 2
MedDRA: Somnolence — Feeling: Good · Chills, 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
2021-04-14
Health check-in — 14 day, dose 2
Feeling: Good

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

Adult check-in
2021-04-28
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-05-12
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-09-29
Survey response — 6 month, dose 2
MedDRA: Abdominal pain upper, Dyspnoea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-09-29
Report sent to call center — 6 month, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-30
Call 1 — Left Voicemail
2021-10-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-31
Survey response — 12 month, dose 2
MedDRA: Arthralgia, Office visit — Feeling: Good · 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
2022-03-31
Report sent to call center — 12 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-05
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-29	Successful 2021-10-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-31	Successful 2022-04-05	Does not wish to fill out VAERS report

Free text

Release 5

Systemic reaction (other): No

Systemic reaction (other): Just a bad headache

Systemic reaction (other): Night sweats

Systemic reaction (other): Pain in lumbar area runs down my leg, feeling bad all day

Systemic reaction (other): My temp usually runs @ 97.1

Symptoms: Body & muscle aches , insomnia , headache's

Healthcare visit (other): Called my Dr

Release 6

Symptoms: Knot like feeling on all my muscles, insomnia could not sleep

Healthcare visit (other): Took melotonin (5 mg)

Systemic reaction (other): Coldness from my feet up wards

Systemic reaction (other): Have been real sleepy since yesterday

Release 7

Systemic reaction (other): Sleepy all day long

Systemic reaction (other): Very sleepy

Release 9

Symptoms: Stomach pains like someone punched you and you run out of breath , Dr looking into it.

Healthcare visit (other): Pcp

Release 11

Symptoms: Joints hurting everywhere

Healthcare visit (other): Chiropractor

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	Self-medication	✓	✓	✓
HCVO	Telemedicine	○	✓	○
SD	Abdominal pain upper	·	·	✓
SD	Arthralgia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Muscle discomfort	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Body temperature normal	✓	✓	○
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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