YY6-75121-85424

3 vaccinations 11 coded responses 31 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 490 / MI
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Tenderness — Feeling: Good · Joint pains

Free text: Lower and middle back tenderness. But could be completely not do to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Tenderness — Feeling: Good · Muscle or body aches

Free text: Back tenderness, but again it sure if it's vaccine related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Dyspnoea — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: Back pain was sharp and hurt to breath for almost 15 hrs. Has gotten better as day has progressed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-13
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Good

Free text: Joint/muscle aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-27
Dose 3 — Moderna
2022-01-29
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore and swelling in lymph nodes in injection arm armpit

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Survey response — days 1–6 daily, dose 3
MedDRA: Headache — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Yesterday a splitting headache!!!!

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Arm pit swelling

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-03
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-02-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-19
Survey response — day 21, dose 3
MedDRA: Headache, Tenderness — Feeling: Fair

Free text: Shot arm tenderness and up into my neck with headache.

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Good

Free text: Dull headache

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Survey response — day 35, dose 3
MedDRA: Headache — Feeling: Good

Free text: Head ache

MedDRA releases: 2024-11 · check-in free text available
2022-03-10
Survey response — day 42, dose 3
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna
3	2022-01-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-15	priority 2/3

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Lower and middle back tenderness. But could be completely not do to the vaccine.

2021-01-14

Systemic reaction (other): Back tenderness, but again it sure if it's vaccine related

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Back pain was sharp and hurt to breath for almost 15 hrs. Has gotten better as day has progressed

Release 8 — 3 months, dose 2

2021-05-08

Symptoms: Joint/muscle aches

Release 11 — days 1–6 daily, dose 3

2022-01-29

Systemic reaction (other): Sore and swelling in lymph nodes in injection arm armpit

2022-01-30

Systemic reaction (other): Yesterday a splitting headache!!!!

2022-01-31

Systemic reaction (other): Arm pit swelling

Release 11 — day 21, dose 3

2022-02-19

Symptoms: Shot arm tenderness and up into my neck with headache.

Release 11 — day 28, dose 3

2022-02-24

Symptoms: Dull headache

Release 11 — day 35, dose 3

2022-03-03

Symptoms: Head ache

Release 11 — day 42, dose 3

2022-03-10

Symptoms: Headache

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
SD	Arthralgia	✓	✓	✓
SD	Headache	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Tenderness	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Tenderness	✓	✓	✓

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