Y6P-76567-23077

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 781 / TX
Registered: 2021-01-25

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

2021-01-23
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Poor · Fever · Chills, Nausea · Be unable to do your normal daily activities

Free text: I had a very minimal procedure done yesterday on my eye lid. They just injected the site with Lidocaine & removed a nodule growth on my left upper eye lid. Ive been using the antibiotic ointment they gave me. Not sure why I just started feeling sick?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Survey response — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe pain from my ankle where the knob is up to my knee. Came on very suddenly yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-20
Survey response — day 28, dose 1
MedDRA: Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: I developed constant nausea (not pregnant!!). It started about 3 weeks ago after my first shot. They postponed our second shot due today because of our weather so we will get it next Saturday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — day 7, dose 2
MedDRA: Condition aggravated, Fibromyalgia, Pre-existing disease, Systemic lupus erythematosus — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Im in a lupus/fibromyalgia flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 14, dose 2
MedDRA: Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Continuous nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 21, dose 2
MedDRA: Asthenia, Chills, Headache, Insomnia, Oropharyngeal pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat, feverish, chills, unable to sleep just feeling weak. Headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swelling of both feet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — 3 months, dose 2
MedDRA: Erythema nodosum — 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: Developed Erythema Nodosum.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Erythema nodosum, Sinusitis — 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: Developed Erythhema Nodosum. Had 3 sinus infections.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2022-02-27
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-02-27	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-29	Unsuccessful
2021-08-30	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): I had a very minimal procedure done yesterday on my eye lid. They just injected the site with Lidocaine & removed a nodule growth on my left upper eye lid. Ive been using the antibiotic ointment they gave me. Not sure why I just started feeling sick?

Release 3 — day 7, dose 1

2021-02-01

Systemic reaction (other): Severe pain from my ankle where the knob is up to my knee. Came on very suddenly yesterday.

Release 4 — day 28, dose 1

2021-02-20

Symptoms: I developed constant nausea (not pregnant!!). It started about 3 weeks ago after my first shot. They postponed our second shot due today because of our weather so we will get it next Saturday.

Release 5 — day 7, dose 2

2021-03-08

Systemic reaction (other): Im in a lupus/fibromyalgia flare up

Release 5 — day 14, dose 2

2021-03-13

Symptoms: Continuous nausea

Release 6 — day 21, dose 2

2021-03-20

Symptoms: Sore throat, feverish, chills, unable to sleep just feeling weak. Headache.

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Swelling of both feet.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Developed Erythema Nodosum.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Developed Erythhema Nodosum. Had 3 sinus infections.

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	Asthenia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Erythema nodosum	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Sinusitis	✓	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Fibromyalgia	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Systemic lupus erythematosus	✓	✓	✓

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