YVG-27299-51124

3 vaccinations 14 coded responses 27 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 720 / AR
Registered: 2021-01-05

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
2021-01-05
Registered in v-safe
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal blistering, Oropharyngeal pain, Pharyngeal erythema, Pharyngeal ulceration, Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: On hand, same arm as injection. Sore in my throat that are red and fluid filled

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: Adenovirus infection, Adverse reaction, Office visit, Oropharyngeal pain — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sores in my throat/went to doctors appt and he said the vaccine affected my immune system and I have adenovirus · Healthcare visit (other): In office visit with my doctor and he said the vaccine caused an immune response and that activated adenovirus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Lymphadenopathy, Oropharyngeal pain, Throat irritation — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore/scratchy throat, swollen glands, a little winded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Runny nose

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

Adult check-in
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Flatulence — Feeling: Fair · 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

Free text: Feel a little winded with activity

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

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Ringing in my ears since injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Call 1 — Left Voicemail
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Ringing in my ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Good · Fatigue or tiredness, Nausea

Free text: Ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-08
Survey response — day 35, dose 2
MedDRA: Eczema, Skin lesion — Feeling: Fair

Free text: Skin lesions that look like eczema

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Arrhythmia, Blood pressure increased, Cardiac monitoring, Office visit — Feeling: Fair · 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: Symptoms: Ive been on a heart monitor. Blood pressure spiked and having cardiac arrhythmias. · Healthcare visit (other): Cardiologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-03
Call 1 — Left Voicemail
2021-10-25
Dose 3 — Moderna
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Fluid retention — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe fluid retention in legs 10 pounds of fluid

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Neck pain — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Neck hurts really bad

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

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

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

Adult check-in
2021-11-08
Survey response — day 14, dose 3
MedDRA: Peripheral swelling — Feeling: Fair

Free text: Swelling in legs

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-10-25
Survey response — 12 months, dose 3
MedDRA: Atrial tachycardia, Office visit — 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

Free text: Symptoms: Since my first Covid vaccine, I've been to numerous cardiologists and have been diagnosed with atrial tachycardia. My symptoms started within a week of the vaccine · Healthcare visit (other): Cardiologists

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
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

1 call case(s)
2022-10-26
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna
3	2021-10-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	Unsuccessful
2021-08-02	Unsuccessful
2022-10-25	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): On hand, same arm as injection. Sore in my throat that are red and fluid filled

2021-01-06

Systemic reaction (other): Sores in my throat/went to doctors appt and he said the vaccine affected my immune system and I have adenovirus

Healthcare visit (other): In office visit with my doctor and he said the vaccine caused an immune response and that activated adenovirus

2021-01-08

Systemic reaction (other): Sore/scratchy throat, swollen glands, a little winded

2021-01-10

Systemic reaction (other): Runny nose

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Feel a little winded with activity

2021-02-05

Systemic reaction (other): Ringing in my ears since injection

2021-02-06

Systemic reaction (other): Ringing in my ears

Release 3 — day 7, dose 2

2021-02-08

Systemic reaction (other): Ringing in ears

Release 5 — day 35, dose 2

2021-03-08

Symptoms: Skin lesions that look like eczema

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: Ive been on a heart monitor. Blood pressure spiked and having cardiac arrhythmias.

Healthcare visit (other): Cardiologist

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Severe fluid retention in legs 10 pounds of fluid

2021-10-28

Systemic reaction (other): Neck hurts really bad

Release 10 — day 14, dose 3

2021-11-08

Symptoms: Swelling in legs

Release 12 — 12 months, dose 3

2022-10-25

Symptoms: Since my first Covid vaccine, I've been to numerous cardiologists and have been diagnosed with atrial tachycardia. My symptoms started within a week of the vaccine

Healthcare visit (other): Cardiologists

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	Adenovirus infection	✓	✓	✓
HCVO	Adverse reaction	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Specialist consultation	○	○	○
SD	Arrhythmia	✓	·	✓
SD	Atrial tachycardia	·	·	✓
SD	Blood pressure increased	✓	·	✓
SD	Cardiac monitoring	✓	·	✓
SD	Eczema	✓	✓	✓
SD	Office visit	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Skin lesion	✓	✓	✓
SRO	Adenovirus infection	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Fluid retention	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Office visit	✓	✓	✓
SRO	Oropharyngeal blistering	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pharyngeal erythema	✓	✓	✓
SRO	Pharyngeal ulceration	○	✓	○
SRO	Rhinorrhoea	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Unevaluable event	✓	·	✓

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