XZL-17404-02817

3 vaccinations 6 coded responses 40 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-01-27

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

2021-01-27
Registered in v-safe
2021-01-27
Dose 1 — Moderna
2021-01-27
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-17
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fever · Chills, 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
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Self-medication — Feeling: Fair · Headache · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal dreams — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-03-10
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-07
Survey response — 42 day, dose 2
MedDRA: Torticollis — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-27
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-26
Health check-in — 0 day, dose 3
Feeling: Good · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 month, dose 3
MedDRA: Cough, Nasopharyngitis, Office visit, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-01-25
Report sent to call center — 3 month, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-09
Call 1 — Could Not Reach Participant
2022-02-11
Call 2 — Could Not Reach Participant
2022-04-26
Survey response — 6 month, dose 3
MedDRA: Cough, Nasopharyngitis, Office visit, Respiratory tract congestion, Self-medication, Wheezing — 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
2022-04-26
Report sent to call center — 6 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-05-03
Call 2 — Requested Callback
2022-05-04
Call 3 — Left Voicemail
2022-10-26
Health check-in — 12 month, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-10-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-25	Unsuccessful
2022-04-26	Unsuccessful

Free text

Release 4

Systemic reaction (other): Sore arm near shot site

Systemic reaction (other): Left side neck spasms (tortecollosis) controlled overnight by 500 tylenol

Systemic reaction (other): Vivid dreams

Release 7

Symptoms: Tortecollosis or neck spasms again

Release 11

Symptoms: Bad cold with cough in mid December, cough still hanging on still. Home covid test negative

Healthcare visit (other): Pulmonologist

Symptoms: Coughing, congestion, wheezing cold- like illness that required doxycycline, benzonatate cough suppression pills, Prednisone, 6+10 days, &Mucinex DM.

Healthcare visit (other): 3 Dr office visits including PCP and pulmonologist

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	Cough	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	·	·	✓
SD	Torticollis	✓	✓	✓
SD	Wheezing	·	·	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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