YZY-21297-63427

3 vaccinations 9 coded responses 30 check-ins 9 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 077 / NJ
Registered: 2021-01-27

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

2021-01-27
Registered in v-safe
2021-01-27
Dose 1 — Moderna
2021-01-27
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Site: Pain

Free text: Nope feel fine, the soreness is comparable to a tetanus shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy, Pre-existing disease — Feeling: Good

Free text: I was diagnosed with CLL lymphoma about 3 years ago but I have no symptoms or problems, it was discovered during my colonoscopy I get every 5 years. Im not sure if its related but I have a swollen lymphnode in my groin about the size of a golf ball so Im being scheduled for a pet scan on 2/10/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My first vaccination was January 27 and on Saturday, January 30 I found a very enlarged lymph node in my groin area the size almost of a small golf ball. I was diagnosed with CLL 3 years ago but no symptoms, Going for a cat scan on 2/13/21 · Healthcare visit (other): Face to face at the office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Survey response — day 21, dose 1
MedDRA: Computerised tomogram abnormal, Neoplasm, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cat scan showed the original large tumor that we knew was there to the left of my groin but displayed very small tumors in my abdomen now, diagnosed in 2018 with CLL Lymphoma but I had no symptoms, 3 days after the 1st shot the large tumor appeared · Healthcare visit (other): Appointments at the (b)(6) cancer center, next step a biopsy and a pet scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Dose 2 — Moderna
2021-02-24
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: Just received the shot 10 minutes ago so feeling fine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Injection site pain — Feeling: Good · Headache

Free text: Just a headache and soreness at the injection point

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — day 7, dose 2
MedDRA: Pre-existing disease — Feeling: Good

Free text: I have Chronic Lymphocytic lymphoma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 35, dose 2
MedDRA: Biopsy, Lymphadenopathy, Lymphoma, Office visit, Positron emission tomogram, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I reported this back in February... after my 1st shot on 1/27 on the morning of 1/30 I woke up with swollen lymph nodes for the 1st time ever since my diagnosis of CLL/SLL lymphoma 3 years ago · Healthcare visit (other): Visited my primary and then my lymphoma doctor and they did pet scans and biopsys of my lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-26
Survey response — 3 months, dose 2
MedDRA: Chronic lymphocytic leukaemia, Lymphadenopathy, Lymphoma, Office visit, Swelling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: CLL lymphoma 3 days after my first moderna shot I woke up with swollen lymph node in my groin · Healthcare visit (other): Doctor visit and did a biopsy and pet scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Call 1 — Left Voicemail
2021-06-11
Call successful
Completed over the phone
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-22
Dose 3 — Moderna
2021-10-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-09-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-12	Successful	Completed over the phone
2021-02-17	Successful	Completed over the phone
2021-03-31	Successful	Completed over the phone
2021-05-26	Successful 2021-06-11	Completed over the phone

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Nope feel fine, the soreness is comparable to a tetanus shot

Release 3 — day 7, dose 1

2021-02-03

Systemic reaction (other): I was diagnosed with CLL lymphoma about 3 years ago but I have no symptoms or problems, it was discovered during my colonoscopy I get every 5 years. Im not sure if its related but I have a swollen lymphnode in my groin about the size of a golf ball so Im being scheduled for a pet scan on 2/10/21

Release 4 — day 14, dose 1

2021-02-12

Symptoms: My first vaccination was January 27 and on Saturday, January 30 I found a very enlarged lymph node in my groin area the size almost of a small golf ball. I was diagnosed with CLL 3 years ago but no symptoms, Going for a cat scan on 2/13/21

Healthcare visit (other): Face to face at the office

Release 4 — day 21, dose 1

2021-02-17

Symptoms: Cat scan showed the original large tumor that we knew was there to the left of my groin but displayed very small tumors in my abdomen now, diagnosed in 2018 with CLL Lymphoma but I had no symptoms, 3 days after the 1st shot the large tumor appeared cut off by CDC

Healthcare visit (other): Appointments at the (b)(6) cancer center, next step a biopsy and a pet scan

redacted (b)(6)

Release 4 — day 0, dose 2

2021-02-24

Systemic reaction (other): Just received the shot 10 minutes ago so feeling fine

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Just a headache and soreness at the injection point

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): I have Chronic Lymphocytic lymphoma

Release 6 — day 35, dose 2

2021-03-31

Symptoms: I reported this back in February... after my 1st shot on 1/27 on the morning of 1/30 I woke up with swollen lymph nodes for the 1st time ever since my diagnosis of CLL/SLL lymphoma 3 years ago

Healthcare visit (other): Visited my primary and then my lymphoma doctor and they did pet scans and biopsys of my lymph nodes

Release 8 — 3 months, dose 2

2021-05-26

Symptoms: CLL lymphoma 3 days after my first moderna shot I woke up with swollen lymph node in my groin

Healthcare visit (other): Doctor visit and did a biopsy and pet scan

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	Biopsy	○	✓	○
HCVO	Lymphoma	○	✓	○
HCVO	Office visit	✓	✓	✓
HCVO	Positron emission tomogram	○	✓	○
SD	Chronic lymphocytic leukaemia	·	·	✓
SD	Computerised tomogram abnormal	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Lymphoma	✓	✓	○
SD	Neoplasm	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Swelling	✓	✓	○
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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