YJM-75418-38795

3 vaccinations 9 coded responses 27 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 721 / AR
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good

Free text: I have autoimmune diseases which have a lot of the same symptom list

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea

Free text: Swollen, painful lymph nodes under arm (injection arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Swollen lymph nodes under arm (injection arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Survey response — day 28, dose 2
MedDRA: Arthritis, Diarrhoea, Flushing, Mucous stools, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: My autoimmune disease is more active: joint inflammation, mucus in bowel movements, episodes of diarrhea, skin flushing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 42, dose 2
MedDRA: Menstruation delayed — Feeling: Good

Free text: My period is late by 14 days, and I am not pregnant. This has literally never happened to me in the 30 years Ive been menstruating.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-09
Dose 3 — Moderna
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Histamine abnormal — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: heightened Histamine reactions

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-10
Survey response — 3 months, dose 3
MedDRA: Blepharospasm, Cough, Diarrhoea, Impaired work ability, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: Good · Be unable to work or attend school

Free text: Eye twitch Diarrhea Runny nose Sneezing Light cough symptoms (other than the eye twitch) required me to not go in to work as per employee health protocol; however, the two rapid Covid-19 tests I took were negative

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Survey response — 6 months, dose 3
MedDRA: Pyelonephritis — 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: Pyelonephritis, February 25-March 8, 2022

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
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)
2022-05-11
Call 1 — Left Voicemail
2022-11-11
Survey response — 12 months, dose 3
MedDRA: COVID-19, Costochondritis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Contracted Covid July 10-18 and again September 29-October 5. Costochondritis September 1-14

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-11-14
Call successful
Participant prefers to complete VAERS report online
2022-11-14
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-11-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-10	Successful 2022-11-14	Participant prefers to complete VAERS report online
2022-11-11	Successful 2022-11-14	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): I have autoimmune diseases which have a lot of the same symptom list

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): Swollen, painful lymph nodes under arm (injection arm)

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Swollen lymph nodes under arm (injection arm)

Release 8 — day 28, dose 2

2021-05-01

Symptoms: My autoimmune disease is more active: joint inflammation, mucus in bowel movements, episodes of diarrhea, skin flushing

Release 8 — day 42, dose 2

2021-05-14

Symptoms: My period is late by 14 days, and I am not pregnant. This has literally never happened to me in the 30 years Ive been menstruating.

Release 10 — days 1–6 daily, dose 3

2021-11-15

Systemic reaction (other): heightened Histamine reactions

Release 11 — 3 months, dose 3

2022-02-10

Symptoms: Eye twitch Diarrhea Runny nose Sneezing Light cough symptoms (other than the eye twitch) required me to not go in to work as per employee health protocol; however, the two rapid Covid-19 tests I took were negative

Release 11 — 6 months, dose 3

2022-05-10

Symptoms: Pyelonephritis, February 25-March 8, 2022

Release 12 — 12 months, dose 3

2022-11-11

Symptoms: Contracted Covid July 10-18 and again September 29-October 5. Costochondritis September 1-14

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	Arthritis	✓	✓	✓
SD	Blepharospasm	·	·	✓
SD	Costochondritis	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Flushing	✓	✓	✓
SD	Impaired work ability	·	·	✓
SD	Menstruation delayed	✓	✓	✓
SD	Mucous stools	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyelonephritis	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sneezing	·	·	✓
SRO	Histamine abnormal	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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