YV2-23589-16747

3 vaccinations 10 coded responses 40 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 472 / IN
Registered: 2021-01-26

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Headache

Free text: Just did vaccine less than 2 hrs ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-23
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Pain in extremity — Feeling: Good

Free text: Discomfort and slight pain under arm which received shot. Swollen lymph node I assume. llen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swollen lymp node in armpit where got shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-08
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling

Free text: Lymp node swollen in arm of shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Survey response — day 21, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in hips and legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-09
Survey response — day 14, dose 3
MedDRA: Cough — Feeling: Good

Free text: Coughing.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Malaise, Office visit, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Was not Covid but same symptoms Tested negative · Healthcare visit (other): Dr

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-26
Survey response — 6 months, dose 3
MedDRA: Alopecia, Antinuclear antibody positive, Autoimmune disorder, Musculoskeletal stiffness, Office visit, Pain, Vitamin B12 decreased — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: ANA blood test indicates autoimmune problem. Symptoms leading to test. Pain, hair loss, stiffness, low B-12. · Healthcare visit (other): In person Dr appt

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-27
Call 1 — Requested Callback
2022-06-06
Call 2 — Left Voicemail
2022-06-06
Call 2 — Left Voicemail
2022-06-06
Callback requested for
09:00AM ET
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Laryngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Laringitis

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-03-01	Moderna
3	2021-10-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-25	Unsuccessful
2022-04-26	Unsuccessful

Free text

Release 2 — day 0, dose 1

2021-01-26

Systemic reaction (other): Just did vaccine less than 2 hrs ago

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Discomfort and slight pain under arm which received shot. Swollen lymph node I assume. llen

2021-03-06

Systemic reaction (other): Swollen lymp node in armpit where got shot

Release 5 — day 7, dose 2

2021-03-08

Systemic reaction (other): Lymp node swollen in arm of shot

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Pain in hips and legs

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Coughing

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Coughing.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Was not Covid but same symptoms Tested negative

Healthcare visit (other): Dr

Release 11 — 6 months, dose 3

2022-04-26

Symptoms: ANA blood test indicates autoimmune problem. Symptoms leading to test. Pain, hair loss, stiffness, low B-12.

Healthcare visit (other): In person Dr appt

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Laringitis

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	Alopecia	·	·	✓
SD	Antinuclear antibody positive	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Autoimmune disorder	·	·	✓
SD	Cough	·	·	✓
SD	Laryngitis	·	·	✓
SD	Malaise	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vitamin B12 decreased	·	·	✓
SRO	Cough	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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