YVN-10669-79871

3 vaccinations 9 coded responses 35 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 024 / MA
Registered: 2021-03-10

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

2021-03-10
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Low apetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-01
Survey response — day 21, dose 1
MedDRA: Autoimmune disorder, Condition aggravated, Feeling abnormal, Pre-existing disease, Sjogren's syndrome — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feeling run down - sjogrens / autoimmune disease seems to be in a small flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Dizziness — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Diarrhea · Be unable to work

Free text: Low apetite, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — day 35, dose 2
MedDRA: Arthritis, Condition aggravated, Pre-existing disease, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection; arthritis / mild sjogrens flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-10
Dose 3 — Moderna
2021-09-10
Survey response — day 0, dose 3
MedDRA: Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Free text: Pain, swelling in left arm (not vaccine arm)

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

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

Adult check-in
2021-09-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · 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

Adult check-in
2021-09-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-09-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-09-17
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-09-24
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-01
Survey response — day 21, dose 3
MedDRA: Sinusitis — 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 · Telehealth, virtual health, or email health consultation

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — day 21, 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)
2021-10-06
Call 2 — Left Voicemail
2021-10-06
Call 2 — Left Voicemail
2021-10-08
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-15
Survey response — day 35, dose 3
MedDRA: Sinusitis, Unevaluable event — 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Sinus infection · Healthcare visit (other): Cat scan

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Report sent to call center — day 35, 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)
2021-10-22
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-10-22
Call 2 — Left Voicemail
2021-12-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-11
Survey response — 6 months, dose 3
MedDRA: Condition aggravated, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Chronic sinus infection; sjogrens flare

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-14
Call 1 — Left Voicemail
2022-09-10
Survey response — 12 months, dose 3
MedDRA: Infection, Pre-existing disease, Staphylococcal infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Staph infections on fingers / nails - connected to autoimmune disease likely · Healthcare visit (other): Antibiotic treatment, procedure to help infection drain

MedDRA releases: 2024-11 · check-in free text available
2022-09-10
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-12
Call 1 — Left Voicemail
2022-09-12
Call 1 — Left Voicemail
2022-09-12
Call 1 — Left Voicemail
2022-09-12
Call 2 — Left Voicemail
2022-09-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-09-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-13	Unsuccessful
2021-10-01	Unsuccessful
2021-10-15	Unsuccessful
2022-03-11	Unsuccessful
2022-09-10	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Low apetite

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Feeling run down - sjogrens / autoimmune disease seems to be in a small flare

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Low apetite, dizzy

Release 8 — day 35, dose 2

2021-05-13

Symptoms: Sinus infection; arthritis / mild sjogrens flare

Release 9 — day 0, dose 3

2021-09-10

Systemic reaction (other): Pain, swelling in left arm (not vaccine arm)

Release 9 — day 21, dose 3

2021-10-01

Symptoms: Sinus infection

Release 10 — day 35, dose 3

2021-10-15

Symptoms: Sinus infection

Healthcare visit (other): Cat scan

Release 11 — 6 months, dose 3

2022-03-11

Symptoms: Chronic sinus infection; sjogrens flare

Release 12 — 12 months, dose 3

2022-09-10

Symptoms: Staph infections on fingers / nails - connected to autoimmune disease likely

Healthcare visit (other): Antibiotic treatment, procedure to help infection drain

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	Infection	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthritis	✓	✓	✓
SD	Autoimmune disorder	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Sjogren's syndrome	✓	✓	✓
SD	Staphylococcal infection	·	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓

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