YXJ-29312-17062

3 vaccinations 13 coded responses 31 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 900 / CA
Registered: 2021-01-28

Relationship: Self
Race: Other
Ethnicity: N/A

Timeline

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Survey response — day 0, dose 1
MedDRA: Feeling abnormal, Immediate post-injection reaction — Feeling: Good · Site: Pain

Free text: 20 Minutes after shot, I felt like a rush of something through my body. Feeling went away after 1 hour.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Contusion, Pain in extremity — Feeling: Fair · Site: Pain · Headache

Free text: My arm felt bruised since yesterday, very painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Slight headache before a walk today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vertigo like feeling every morning for the past 2 Days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Headache

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: I always feel tired all day everyday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school

Free text: Fatigue- horrible fatigue

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-06
Dose 3 — Moderna
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Nausea, Abdominal pain · Be unable to work or attend school

Free text: PAIN UNDER ARMPIT UNABLE TO WORK!

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · Site: Pain, Swelling · Be unable to work or attend school

Free text: PAIN UNDER LEFT ARMPIT

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Impaired work ability — Feeling: Fair · Fatigue or tiredness, Abdominal pain · 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: Systemic reaction (other): PAIN UNDER LEFT ARMPIT · Healthcare visit (other): Unable to work!

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Report sent to call center — days 1–6 daily, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Impaired work ability, Malaise — Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness, Nausea · 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: Horrible fatigue unable to work! Who will pay the bills?? 6 Days of feeling like CRAP.

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Report sent to call center — days 1–6 daily, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · 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, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: PAIN UNDER LEFT ARM

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Report sent to call center — days 1–6 daily, 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)
2021-12-13
Health check-in — day 7, dose 3
Feeling: Fair · Chills, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-12-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-10	Unsuccessful
2021-12-11	Unsuccessful
2021-12-12	Unsuccessful

Free text

Release 3 — day 0, dose 1

2021-01-28

Systemic reaction (other): 20 Minutes after shot, I felt like a rush of something through my body. Feeling went away after 1 hour.

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): My arm felt bruised since yesterday, very painful.

2021-01-31

Systemic reaction (other): Slight headache before a walk today

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Light headed

2021-02-28

Systemic reaction (other): Vertigo like feeling every morning for the past 2 Days

2021-03-01

Systemic reaction (other): Light headed

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: I always feel tired all day everyday.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Fatigue- horrible fatigue

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): PAIN UNDER ARMPIT UNABLE TO WORK!

2021-12-09

Systemic reaction (other): PAIN UNDER LEFT ARMPIT

2021-12-10

Systemic reaction (other): PAIN UNDER LEFT ARMPIT

Healthcare visit (other): Unable to work!

2021-12-11

Systemic reaction (other): Horrible fatigue unable to work! Who will pay the bills?? 6 Days of feeling like CRAP.

2021-12-12

Systemic reaction (other): PAIN UNDER LEFT ARM

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	Impaired work ability	·	·	✓
SD	Fatigue	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Impaired work ability	·	·	✓
SRO	Malaise	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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