YU2-16694-39077

3 vaccinations 13 coded responses 29 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 255 / WV
Registered: 2021-03-24

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

2021-03-04
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Survey response — day 14, dose 1
MedDRA: Injection site nodule, Pain in extremity, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: Had a fever the day following my vaccine. My arm hurt. My arm hurt for 2 weeks and had a knot where the shot was administered.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — day 21, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Axillary mass — Feeling: Good

Free text: Lumps under my arm pits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 21, dose 2
MedDRA: Oedema peripheral, Rash, Rash erythematous — Feeling: Fair

Free text: Armpits still swollen with red bumps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 28, dose 2
MedDRA: Cough, Oropharyngeal pain, SARS-CoV-2 test — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Cough and sore throat. Low grade temperature 99 degrees. I went and got a COVID test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Diarrhoea, Ear infection, Tooth infection — 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: Eye infection, tooth infection root canal, diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-08
Dose 3 — Moderna
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Eye swelling, Pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen eyes and ears throbbing

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

Adult check-in
2021-11-11
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My lymph nodes under my arms are swollen and sore, especially the left armpit that's the same left arm I received my vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lymph nodes in left armpit where I received booster still painful, red, and swollen

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — day 7, dose 3
MedDRA: Erythema, Lymph node pain, Lymphadenopathy, Rash — Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches

Free text: Left armpit lymph nodes still red, bumps, swollen and sore

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 14, dose 3
MedDRA: Vomiting — Feeling: Good · Be unable to work or attend school

Free text: Vomiting last Wednesday 11/17

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Survey response — day 21, dose 3
MedDRA: Arthralgia — Feeling: Good

Free text: Achy joints

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-09
Survey response — 6 months, dose 3
MedDRA: Fluid retention, Office visit, Swelling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling a fluid retention · Healthcare visit (other): Doctor visit with my regular doctor

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-11-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-01	Successful 2021-07-06	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-09	Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-03-24

Symptoms: Had a fever the day following my vaccine. My arm hurt. My arm hurt for 2 weeks and had a knot where the shot was administered.

Release 6 — day 21, dose 1

2021-03-28

Symptoms: Sore throat

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Lumps under my arm pits

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Armpits still swollen with red bumps

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Cough and sore throat. Low grade temperature 99 degrees. I went and got a COVID test.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Eye infection, tooth infection root canal, diarrhea

Release 10 — days 1–6 daily, dose 3

2021-11-09

Systemic reaction (other): Swollen eyes and ears throbbing

2021-11-11

Systemic reaction (other): My lymph nodes under my arms are swollen and sore, especially the left armpit that's the same left arm I received my vaccine.

2021-11-14

Systemic reaction (other): Lymph nodes in left armpit where I received booster still painful, red, and swollen

Release 10 — day 7, dose 3

2021-11-15

Systemic reaction (other): Left armpit lymph nodes still red, bumps, swollen and sore

Release 10 — day 14, dose 3

2021-11-22

Symptoms: Vomiting last Wednesday 11/17

Release 10 — day 21, dose 3

2021-11-29

Symptoms: Achy joints

Release 11 — 6 months, dose 3

2022-05-09

Symptoms: Swelling a fluid retention

Healthcare visit (other): Doctor visit with my regular doctor

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	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Axillary mass	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Fluid retention	·	·	✓
SD	Injection site nodule	✓	✓	✓
SD	Oedema peripheral	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	Swelling	·	·	✓
SD	Tooth infection	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Erythema	·	·	✓
SRO	Eye swelling	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Pain	·	·	✓
SRO	Rash	·	·	✓

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