YWD-21247-07057

2 vaccinations 7 coded responses 26 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 222 / VA
Registered: 2021-03-04

Relationship: Self
Race: Multiracial
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
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Chills, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Nausea, Diarrhea

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Good · Chills

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Ear pain, Headache, Injection site pain, Myalgia, Pain in jaw, Self-medication, Spinal pain, Temporomandibular joint syndrome — Feeling: Fair · Site: Pain, 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: Exactly 32 hours after vaccine#2, severe symptoms began, joint pain to the point of not being able to bear weight on right leg( pain at MCL knee), right hip,jaw, TMJ, ear pain, headache stabbing and intermittent, c spine pain and muscle ache all over like the flu. Tylenol helped a little bit much. I felt unable to do anything other that go to bed. Symptoms resolved just as suddenly after 4 hours. I am a medical provider reporting these side effects. This am, I feel normal with only slight pain at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Left supraclavicular lymph node tenderness and swelling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling · Fatigue or tiredness

Free text: Supraclavicular lymphadenopathy resolved. Lasted about 36 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Lymphadenopathy, Muscle oedema — Feeling: Good · Site: Swelling · Chills, Muscle or body aches

Free text: Symptoms are noted only in the early evening; again noted supraclavicular LN left and fairly significant edema of the left deltoid, chills for about 2 hrs in the evening.. hot shower and Celebrex helped. No sx. In morning. Will see if they return this evening...very strange S. E.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 7, dose 2
MedDRA: Headache, Lymphadenopathy, Sinusitis — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Still have enlarged SCLN left. Also have sinus infection, thus the HA · Healthcare visit (other): Don't believe sx. Are vaccine related except enlarged Lymph node

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
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
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-11
Call 1 — Left Voicemail
2022-02-22
Call 2 — Left Voicemail
2022-04-01
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-08	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): Dizziness

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Dizziness

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Exactly 32 hours after vaccine#2, severe symptoms began, joint pain to the point of not being able to bear weight on right leg( pain at MCL knee), right hip,jaw, TMJ, ear pain, headache stabbing and intermittent, c spine pain and muscle ache all over like the flu. Tylenol helped a little bit much. I felt unable to do anything other that go to bed. Symptoms resolved just as suddenly after 4 hours. I am a medical provider reporting these side effects. This am, I feel normal with only slight pain at injection site.

2021-04-04

Systemic reaction (other): Left supraclavicular lymph node tenderness and swelling.

2021-04-05

Systemic reaction (other): Supraclavicular lymphadenopathy resolved. Lasted about 36 hours

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Symptoms are noted only in the early evening; again noted supraclavicular LN left and fairly significant edema of the left deltoid, chills for about 2 hrs in the evening.. hot shower and Celebrex helped. No sx. In morning. Will see if they return this evening...very strange S. E.

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Still have enlarged SCLN left. Also have sinus infection, thus the HA

Healthcare visit (other): Don't believe sx. Are vaccine related except enlarged Lymph node

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	Lymphadenopathy	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Muscle oedema	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinusitis	✓	✓	✓
SRO	Spinal pain	✓	✓	✓
SRO	Temporomandibular joint syndrome	✓	✓	✓

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