Y2U-26034-82574

4 vaccinations 12 coded responses 45 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 846 / UT
Registered: 2021-03-03

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Good · Site: Itching · Headache, Muscle or body aches, Nausea

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Breast tenderness, Chest pain, Pain, Pyrexia, Throat irritation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Scratchy throat. Yesterday I had a lower grade fever after my health check. I also have tenderness in my left arm. Left clavicle and left chest area achy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site reaction, Irritability, Office visit, Sinus pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: I went to see the doctor today because my injection is gotten larger. About 6.5 inches across. He prescribed Bactrim to treat my skin. Some irritability today. And sinus pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Dizziness, Head discomfort — Feeling: Poor · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, heaviness in my head.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — day 0, dose 2
MedDRA: Dizziness, Hyperaesthesia teeth, Pain — Feeling: Fair · Site: Pain, Swelling · Joint pains

Free text: Sore Clavicle on side of vaccine. Sensitivity on my teeth, lightheadness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Pain in extremity, Pain in jaw — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Pain under my armpit area on both sides. Pain on my jaw. And pain on inside of legs. Since yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Night sweats, Oedema peripheral, Pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: My doctor prescribed Meloxicam 15mg. For the pain. I had night sweats. Swelling under my right armpit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

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

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

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

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

Adult check-in
2021-05-12
Survey response — day 42, dose 2
MedDRA: Burning sensation, Rash erythematous — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Not sure if it's related or not. But getting a red rash on my under arm felt like burning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-22
Survey response — day 0, dose 3
MedDRA: Supraclavicular fossa pain — Feeling: Fair · Site: Itching

Free text: Just a little clavicle pain. I received the Moderna Booster

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · Chills, Headache

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Injection site erythema, Injection site pruritus, Injection site reaction, Urticaria — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Nausea

Free text: Welt near injection site. With redness and itches. Pain started in my armpit area on the injection site arm

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness · None

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

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

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Survey response — day 14, dose 3
MedDRA: Abdominal pain, Chest pain, Dyspnoea, Heart rate increased, Muscle fatigue, Muscle spasms — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I expressed burning in center of my chest, shortness of breath, faster heart rate. Right side abdominal pain. Muscle spasms in my upper back the worsened when laying on my back. Also muscle fatigue in my arms in legs. I went to see doctor. Labs norma

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-10
Call 1 — Left Voicemail
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-12
Call 2 — Could Not Reach Participant
2021-11-12
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-13
Dose 4 — Moderna
2022-10-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-13
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-14
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-10-22	Moderna	No
4	2022-09-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-12	Unsuccessful
2021-11-05	Successful 2021-11-12	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Scratchy throat. Yesterday I had a lower grade fever after my health check. I also have tenderness in my left arm. Left clavicle and left chest area achy.

2021-03-07

Systemic reaction (other): Irritability

2021-03-08

Systemic reaction (other): I went to see the doctor today because my injection is gotten larger. About 6.5 inches across. He prescribed Bactrim to treat my skin. Some irritability today. And sinus pain.

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): Dizziness, heaviness in my head.

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): Sore Clavicle on side of vaccine. Sensitivity on my teeth, lightheadness.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Pain under my armpit area on both sides. Pain on my jaw. And pain on inside of legs. Since yesterday.

2021-04-02

Systemic reaction (other): My doctor prescribed Meloxicam 15mg. For the pain. I had night sweats. Swelling under my right armpit.

2021-04-03

Systemic reaction (other): Dizziness

Release 8 — day 42, dose 2

2021-05-12

Symptoms: Not sure if it's related or not. But getting a red rash on my under arm felt like burning.

Release 10 — day 0, dose 3

2021-10-22

Systemic reaction (other): Just a little clavicle pain. I received the Moderna Booster

Release 10 — days 1–6 daily, dose 3

2021-10-25

Systemic reaction (other): Welt near injection site. With redness and itches. Pain started in my armpit area on the injection site arm

Release 10 — day 14, dose 3

2021-11-05

Symptoms: I expressed burning in center of my chest, shortness of breath, faster heart rate. Right side abdominal pain. Muscle spasms in my upper back the worsened when laying on my back. Also muscle fatigue in my arms in legs. I went to see doctor. Labs norma cut off by CDC

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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	Abdominal pain	·	·	✓
SD	Burning sensation	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Muscle fatigue	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Rash erythematous	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Breast tenderness	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Hyperaesthesia teeth	✓	✓	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pruritus	·	·	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	○
SRO	Night sweats	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Office visit	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Supraclavicular fossa pain	·	·	✓
SRO	Throat irritation	✓	✓	✓
SRO	Urticaria	·	·	✓

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