YRV-13681-45380

3 vaccinations 7 coded responses 40 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 983 / WA
Registered: 2021-01-05

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

7N4-87537-07405 Child or adolescent in my care · Male · 2021-11-11

UQG-62955-09916 Child or adolescent in my care · Female · 2021-11-11

PKW-16603-36474 Child or adolescent in my care · Male · 2022-01-21

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Fatigue or tiredness

Free text: Sore throat since yesterday evening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: Lightheaded starting about 1 he after injection that lasted for about 2hours. Better now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Pain, Tinnitus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing in ears and shorting pain intermittently up the back of my head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort — Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pressure in ear on injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-13
Survey response — day 14, dose 2
MedDRA: Arthralgia, Lymphadenopathy, Myalgia — Feeling: Good

Free text: Tender lymph nodes in armpits and groin, intermittent joint and muscle pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — 3 months, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Chronic hip pain bilaterally -tolerable but mostly constant

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-08
Dose 3 — Moderna
2021-12-08
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Electric shock sensation, Neck pain, Pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Electrical shooting pain up ipsilateral neck

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-12-15
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-08
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-01-29	Moderna
3	2021-12-08	Moderna	No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Systemic reaction (other): Sore throat since yesterday evening

Release 3 — day 0, dose 2

2021-01-29

Systemic reaction (other): Lightheaded starting about 1 he after injection that lasted for about 2hours. Better now

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Ringing in ears and shorting pain intermittently up the back of my head

2021-01-31

Systemic reaction (other): Pressure in ear on injection side

Release 4 — day 14, dose 2

2021-02-13

Symptoms: Tender lymph nodes in armpits and groin, intermittent joint and muscle pain

Release 8 — 3 months, dose 2

2021-04-30

Symptoms: Chronic hip pain bilaterally -tolerable but mostly constant

Release 10 — days 1–6 daily, dose 3

2021-12-09

Systemic reaction (other): Electrical shooting pain up ipsilateral neck

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	Arthralgia	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Myalgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Electric shock sensation	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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