YK4-20487-13074

3 vaccinations 12 coded responses 33 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 302 / GA
Registered: 2021-01-10

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

2021-01-04
Dose 1 — Moderna
2021-01-10
Registered in v-safe
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza virus test negative, SARS-CoV-2 test negative, Sinusitis, Swelling — Feeling: Fair · Site: Swelling · Fatigue or tiredness

Free text: Swollen area, possibly a lymphnode near collar bone. I was also dx'd with a sinus infection 1-07-21 and started the z-pac the same day. I qas tested for Covid and Flu on 1-08-21, per my PCP. Both negative rapid test results.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Fatigue or tiredness

Free text: Still have a swollen area in my neck, possibly a lymphnode. Could be related or unrelated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tiredness

Free text: Swollen lymphnode in neck/collarbone area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 21, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-10-27
Dose 3 — Moderna
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore Throat

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Joint and muscle pain was last night.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-10
Survey response — day 14, dose 3
MedDRA: Discharge, Fatigue, Respiratory tract congestion — Feeling: Good

Free text: Congestion, drainage, tiredness.

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Survey response — day 21, dose 3
MedDRA: Ear pain, Epistaxis, Fatigue, Respiratory tract congestion, Rhinorrhoea, Sputum discoloured — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Ear pain, congestion, bloody and yellow nasal discharge. Tiredness

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-18
Call successful
Participant prefers to complete VAERS report online
2021-11-24
Survey response — day 28, dose 3
MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Diagnosed with a Sinus Infection on 11/19/21. Negative Covid Test.

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Fatigue, Headache, Influenza virus test negative, Nausea, SARS-CoV-2 test negative — Feeling: Poor · 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

Free text: Nausea, diarrhea, tiredness, headache. Tested negative for Rapid and PCR Covid and Flu.

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 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 · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail
2022-10-29
Survey response — 12 months, dose 3
MedDRA: COVID-19 — 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 · Outpatient clinic or urgent care clinic visit

Free text: Covid Positive on 10/08/22.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-05	Moderna
3	2021-10-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-17	Successful 2021-11-18	Participant prefers to complete VAERS report online
2022-01-28	Unsuccessful
2022-10-29	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Swollen area, possibly a lymphnode near collar bone. I was also dx'd with a sinus infection 1-07-21 and started the z-pac the same day. I qas tested for Covid and Flu on 1-08-21, per my PCP. Both negative rapid test results.

Release 1 — day 7, dose 1

2021-01-11

Systemic reaction (other): Still have a swollen area in my neck, possibly a lymphnode. Could be related or unrelated.

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Swollen lymphnode in neck/collarbone area

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Sore throat

Release 4 — day 21, dose 2

2021-02-26

Symptoms: Sore throat

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Sore Throat

2021-10-29

Systemic reaction (other): Joint and muscle pain was last night.

Release 10 — day 14, dose 3

2021-11-10

Symptoms: Congestion, drainage, tiredness.

Release 10 — day 21, dose 3

2021-11-17

Symptoms: Ear pain, congestion, bloody and yellow nasal discharge. Tiredness

Release 10 — day 28, dose 3

2021-11-24

Symptoms: Diagnosed with a Sinus Infection on 11/19/21. Negative Covid Test.

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Nausea, diarrhea, tiredness, headache. Tested negative for Rapid and PCR Covid and Flu.

Release 12 — 12 months, dose 3

2022-10-29

Symptoms: Covid Positive on 10/08/22.

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	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Discharge	·	·	✓
SD	Ear pain	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sputum discoloured	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Influenza virus test negative	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓
SRO	Sinusitis	✓	✓	✓
SRO	Swelling	✓	✓	✓

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