YSV-13563-51373

3 vaccinations 18 coded responses 38 check-ins 18 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 336 / FL
Registered: 2021-01-02

Relationship: Self
Race: N/A
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Moderna
2021-01-02
Survey response — day 0, dose 1
MedDRA: Paraesthesia oral, Pharyngeal paraesthesia — Feeling: Good · Joint pains, Muscle or body aches

Free text: Short time tingling on lips, tongue, throat. Went away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia oral, Throat irritation — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Short episodes of tingling on lips, tongue & scratchy throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Paraesthesia oral — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Episodes of tinglIng sensation mainly on lips, a bit on tongue too. Mild nasal stuffiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia, Paraesthesia oral — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Episodes of tingling on lips and a bit on tongue (like pins and needles)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Paraesthesia oral, Throat irritation — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Mild episodes of tingling of the lips and tongue, mild stuffy nose & scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia oral — Feeling: Good · Joint pains

Free text: Less episodes of mild tingling on lips and tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-09
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Survey response — day 0, dose 2
MedDRA: Paraesthesia oral — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Short Episodes of tingling sensation on lips and tongue

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: Paraesthesia oral — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Episodes of mild tingling in tongue

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: Paraesthesia, Paraesthesia oral — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Episodes of tingling on lips legs snd tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Survey response — day 21, dose 2
MedDRA: Fatigue, Pain, Vertigo — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Worsening fatigue, vertigo, and body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — day 21, 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)
2021-02-26
Survey response — day 28, dose 2
MedDRA: Dizziness, Fatigue, Hyperthyroidism, Pre-existing disease, 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Feeling super tired and dizzy Went hyperthyroid after being hypo all my life WBCs on low end of range · Healthcare visit (other): Labs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 28, 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)
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-04-30
Survey response — 3 months, dose 2
MedDRA: Blood thyroid stimulating hormone abnormal, Drug hypersensitivity — Feeling: Fair · Be unable to work, 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: Changes in TSH, serious allergic reaction to medicine I wasnt allergic to before

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — 3 months, 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)
2021-06-07
Call 1 — Left Voicemail
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Arm pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, 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: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Free text: Swelling under arm of injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Report sent to call center — days 1–6 daily, 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 · 1 call case(s)
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swelling and pain under arm where I received the vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Call 1 — Left Voicemail
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness and swelling and pain underneath injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — day 7, dose 3
MedDRA: Axillary pain, Dizziness, Oedema peripheral — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness and swelling and pain underneath arm where shot given

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-10-29
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-29	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-03	priority 2/3
2021-01-09	priority 2/3
2021-02-19	Unsuccessful
2021-02-26	Unsuccessful
2021-04-30	Unsuccessful
2021-11-02	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-02

Systemic reaction (other): Short time tingling on lips, tongue, throat. Went away

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Short episodes of tingling on lips, tongue & scratchy throat.

2021-01-04

Systemic reaction (other): Episodes of tinglIng sensation mainly on lips, a bit on tongue too. Mild nasal stuffiness

2021-01-05

Systemic reaction (other): Episodes of tingling on lips and a bit on tongue (like pins and needles)

2021-01-06

Systemic reaction (other): Mild episodes of tingling of the lips and tongue, mild stuffy nose & scratchy throat

2021-01-07

Systemic reaction (other): Less episodes of mild tingling on lips and tongue

Release 3 — day 0, dose 2

2021-01-29

Systemic reaction (other): Short Episodes of tingling sensation on lips and tongue

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Episodes of mild tingling in tongue

2021-01-31

Systemic reaction (other): Episodes of tingling on lips legs snd tongue

2021-02-01

Systemic reaction (other): Dizziness

Release 4 — day 21, dose 2

2021-02-19

Symptoms: Worsening fatigue, vertigo, and body aches

Release 4 — day 28, dose 2

2021-02-26

Symptoms: Feeling super tired and dizzy Went hyperthyroid after being hypo all my life WBCs on low end of range

Healthcare visit (other): Labs

Release 8 — 3 months, dose 2

2021-04-30

Symptoms: Changes in TSH, serious allergic reaction to medicine I wasnt allergic to before

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Arm pain

2021-11-02

Systemic reaction (other): Swelling under arm of injection

2021-11-03

Systemic reaction (other): Swelling and pain under arm where I received the vaccine

2021-11-04

Systemic reaction (other): Dizziness and swelling and pain underneath injection arm

Release 10 — day 7, dose 3

2021-11-05

Systemic reaction (other): Dizziness and swelling and pain underneath arm where shot given

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	Unevaluable event	✓	✓	✓
SD	Blood thyroid stimulating hormone abnormal	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Drug hypersensitivity	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hyperthyroidism	✓	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Vertigo	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pharyngeal paraesthesia	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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