YAQ-12683-70355

3 vaccinations 10 coded responses 28 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 352 / AL
Registered: 2021-04-06

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Survey response — day 14, dose 1
MedDRA: Cough, Headache, Injection site erythema, Injection site pain, Injection site swelling, Pain, Respiratory tract congestion — Feeling: Good · Be unable to work

Free text: Swollen injection site that itched and was red, and mildly painful to the touch. I also ended up with a cold on 4/14/2021 that warranted congestion, slight cough, headache & body aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 28, dose 1
MedDRA: Breast inflammation, Lymphadenopathy, Mammogram abnormal, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: MRI mammogram showed inflammation of n my breasts and swollen lymph nodes · Healthcare visit (other): OB/GYN

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Dose 2 — Moderna
2021-05-11
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary mass, Lip swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches

Free text: Swollen lips; lump under left armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Survey response — day 14, dose 2
MedDRA: Breast inflammation, Lymphadenopathy, Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Inflammation in my breast & swollen lymph nodes. · Healthcare visit (other): MRI biopsy & biopsy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-01
Survey response — day 21, dose 2
MedDRA: Asthenia, Hypoaesthesia, Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Weakness and intermittent numbness in my left arm. And swollen lymph nodes · Healthcare visit (other): Doctor visits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Survey response — day 28, dose 2
MedDRA: Hypoaesthesia, Pain, Pain in extremity — Feeling: Good

Free text: Numbing and pain moving my left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Survey response — day 35, dose 2
MedDRA: Hypoaesthesia, Muscular weakness — Feeling: Good

Free text: Intermittent numbness and weakness in my left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Call 1 — Left Voicemail
2021-08-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Survey response — 6 months, dose 2
MedDRA: Cough, Sinus congestion, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough; scratchy throat; sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Dose 3 — Moderna
2022-06-07
Survey response — 3 months, dose 3
MedDRA: Fatigue, Headache, Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Be unable to work or attend school

Free text: Fatigue, congestion, runny nose, headache

MedDRA releases: 2024-11 · check-in free text available
2022-09-06
Survey response — 6 months, dose 3
MedDRA: Headache, Oropharyngeal pain, Pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Sore throat, body aches, headaches

MedDRA releases: 2024-11 · check-in free text available
2022-09-06
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-09-07
Call 1 — Left Voicemail
2022-09-07
Call 1 — Left Voicemail
2022-09-07
Call 2 — Left Voicemail
2022-09-07
Call 1 — Left Voicemail
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2022-09-07
Call successful
Participant prefers to complete VAERS report online
2023-03-10
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-11	Moderna
3	2022-03-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-06	Successful 2022-09-07	Participant prefers to complete VAERS report online
2021-05-25	Successful 2022-09-07	Participant prefers to complete VAERS report online
2021-06-01	Successful 2022-09-07	Participant prefers to complete VAERS report online
2022-09-06	Successful 2022-09-07	Participant prefers to complete VAERS report online

Free text

Release 7 — day 14, dose 1

2021-04-20

Symptoms: Swollen injection site that itched and was red, and mildly painful to the touch. I also ended up with a cold on 4/14/2021 that warranted congestion, slight cough, headache & body aches.

Release 8 — day 28, dose 1

2021-05-06

Symptoms: MRI mammogram showed inflammation of n my breasts and swollen lymph nodes

Healthcare visit (other): OB/GYN

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Swollen lips; lump under left armpit

Release 8 — day 14, dose 2

2021-05-25

Symptoms: Inflammation in my breast & swollen lymph nodes.

Healthcare visit (other): MRI biopsy & biopsy

Release 8 — day 21, dose 2

2021-06-01

Symptoms: Weakness and intermittent numbness in my left arm. And swollen lymph nodes

Healthcare visit (other): Doctor visits

Release 8 — day 28, dose 2

2021-06-08

Symptoms: Numbing and pain moving my left arm

Release 9 — day 35, dose 2

2021-06-15

Symptoms: Intermittent numbness and weakness in my left arm

Release 10 — 6 months, dose 2

2021-11-10

Symptoms: Cough; scratchy throat; sinus congestion

Release 11 — 3 months, dose 3

2022-06-07

Symptoms: Fatigue, congestion, runny nose, headache

Release 12 — 6 months, dose 3

2022-09-06

Symptoms: Sore throat, body aches, headaches

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
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Breast inflammation	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Mammogram abnormal	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Axillary mass	✓	✓	✓
SRO	Lip swelling	✓	✓	✓

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