YH3-30927-06774

3 vaccinations 6 coded responses 29 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 894 / NV
Registered: 2021-01-18

Relationship: Self
Race: White
Ethnicity: N/A

Registered dependents

3HG-29211-84180 Child or adolescent in my care · Female · 2021-11-19

P9Z-14050-74506 Child or adolescent in my care · Female · 2021-11-19

Timeline

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Moderna
2021-01-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — day 7, dose 1
MedDRA: Axillary pain — Feeling: Good

Free text: Armpit pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — day 14, dose 1
MedDRA: Axillary pain — Feeling: Good

Free text: Armpit pain. Not terrible, but noticeable. As a women it is a little worrisome because it could be a symptoms of breast cancer, but pretty sure its from the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-22
Survey response — day 7, dose 2
MedDRA: Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Itching on the rash that is not at the injection site (opposite side of arm from the spot where injected, near armpit).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 14, dose 2
MedDRA: Joint dislocation, Office visit, Pain, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My arm continues to have localized pain (not at injection site), and last week my wrist bone popped out. I went to urgent care and they could not explain why. They even took x-rays of my wrist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-17
Call 1 — Left Voicemail
2021-11-16
Dose 3 — Moderna
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain, Swelling · Headache

Free text: Sore armpit and swollen armpit. This is where pain is mostly.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-16
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: COVID

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Moderna
2	2021-02-15	Moderna
3	2021-11-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-01	Unsuccessful

Free text

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): Armpit pain

Release 3 — day 14, dose 1

2021-02-01

Symptoms: Armpit pain. Not terrible, but noticeable. As a women it is a little worrisome because it could be a symptoms of breast cancer, but pretty sure its from the vaccine.

Release 4 — day 7, dose 2

2021-02-22

Systemic reaction (other): Itching on the rash that is not at the injection site (opposite side of arm from the spot where injected, near armpit).

Release 4 — day 14, dose 2

2021-03-01

Symptoms: My arm continues to have localized pain (not at injection site), and last week my wrist bone popped out. I went to urgent care and they could not explain why. They even took x-rays of my wrist.

Release 10 — days 1–6 daily, dose 3

2021-11-19

Systemic reaction (other): Sore armpit and swollen armpit. This is where pain is mostly.

Release 12 — 12 months, dose 3

2022-11-16

Symptoms: COVID

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	Axillary pain	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Joint dislocation	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Rash pruritic	✓	✓	✓

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