Y8W-17454-31119

3 vaccinations 9 coded responses 34 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 940 / CA
Registered: 2021-03-13

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-11
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Fair · Headache

Adult check-in
2021-03-25
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: I believe I have a swollen lymph node in my left arm pit. This is the side I received the vaccine on 2 weeks ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 21, dose 1
MedDRA: Pre-existing disease, Pruritus, Urticaria — Feeling: Good

Free text: Became very itchy 3/29, had hives on both arms for about 12 hours. Have a Hx of atopic dermatitis and take antihistamines daily.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Have had intermittent diarrhea since 4/4/2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-12-06
Dose 3 — Moderna
2021-12-06
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Fever · Headache

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Survey response — day 7, dose 3
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node is armpit on the side I was injected

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Survey response — day 14, dose 3
MedDRA: Menstruation irregular — Feeling: Fair

Free text: I had what seemed like an extra menstrual cycle (my actual one started 12/5) Last 3 days. This started 12/17-12/19

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-12
Survey response — day 35, dose 3
MedDRA: Pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school

Free text: Transient sore nasopharynx, mild congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Survey response — day 42, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-02-19
Call 1 — Could Not Reach Participant
2022-02-24
Call 2 — Could Not Reach Participant
2022-06-06
Survey response — 6 months, dose 3
MedDRA: Gingival bleeding — Feeling: Good

Free text: Bleeding gums

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-12-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-13	Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-03-25

Symptoms: I believe I have a swollen lymph node in my left arm pit. This is the side I received the vaccine on 2 weeks ago.

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Became very itchy 3/29, had hives on both arms for about 12 hours. Have a Hx of atopic dermatitis and take antihistamines daily.

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Have had intermittent diarrhea since 4/4/2021

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): Sweating

Release 10 — day 7, dose 3

2021-12-13

Systemic reaction (other): Swollen lymph node is armpit on the side I was injected

Release 10 — day 14, dose 3

2021-12-20

Symptoms: I had what seemed like an extra menstrual cycle (my actual one started 12/5) Last 3 days. This started 12/17-12/19

Release 10 — day 35, dose 3

2022-01-12

Symptoms: Transient sore nasopharynx, mild congestion

Release 10 — day 42, dose 3

2022-01-17

Symptoms: Sore throat, congestion

Release 11 — 6 months, dose 3

2022-06-06

Symptoms: Bleeding gums

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	Gingival bleeding	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Menstruation irregular	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Urticaria	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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