ZVY-20939-98592

4 vaccinations 13 coded responses 37 check-ins 12 free-text entries 3 call cases

Sex: —
Age at first dose: 46-50
ZIP prefix: 347 / FL
Registered: 2021-01-13

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

ASP-12963-33569 Child or adolescent in my care · Female · 2022-06-27

Timeline

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Good · Site: Pain

Free text: Lymph node painful in left axilla which is the side I got the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Good

Free text: Lymph node still a little tender but not as bad as yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good

Free text: Under arm still a little sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Lymph node is starting to freak me out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Discomfort, Lymphadenopathy — Feeling: Good

Free text: Lymph node still enlarged and uncomfortable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 7, dose 2
MedDRA: Lymph node pain — Feeling: Poor · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: Lymphode dull achy pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 14, dose 2
MedDRA: Discomfort, Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lymphadenopathy on the left side under arm and along chest. Uncomfortable at times. Had mammogram on 2/23/21 and that was clear. Need to schedule MRI. · Healthcare visit (other): Mammogram

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 28, dose 2
MedDRA: Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme nausea 3/10/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Survey response — 6 months, dose 2
MedDRA: Malaise — Feeling: Fair

Free text: Feel like crap

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Call successful
Participant prefers to complete VAERS report online
2021-11-10
Dose 3 — Pfizer-BioNTech
2022-02-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-11
Survey response — 6 months, dose 3
MedDRA: Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chronic headache

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Dose 4 — Pfizer-BioNTech
Co-administered: Tetanus
2022-06-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-06-28
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-07-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-23
Survey response — 3 months, dose 4
MedDRA: Flank pain — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pain in right side

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-20
Survey response — 6 months, dose 4
MedDRA: Headache, Neck pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Headache, neck pain,

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-12-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-21
Survey response — 12 months, dose 4
MedDRA: Abdominal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-11-10	Pfizer-BioNTech	No
4	2022-06-21	Pfizer-BioNTech	Tetanus

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Lymph node painful in left axilla which is the side I got the shot

2021-02-13

Systemic reaction (other): Lymph node still a little tender but not as bad as yesterday

2021-02-14

Systemic reaction (other): Under arm still a little sore

2021-02-15

Systemic reaction (other): Lymph node is starting to freak me out

2021-02-16

Systemic reaction (other): Lymph node still enlarged and uncomfortable

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): Lymphode dull achy pain

Release 4 — day 14, dose 2

2021-02-24

Symptoms: Lymphadenopathy on the left side under arm and along chest. Uncomfortable at times. Had mammogram on 2/23/21 and that was clear. Need to schedule MRI.

Healthcare visit (other): Mammogram

Release 5 — day 28, dose 2

2021-03-10

Symptoms: Extreme nausea 3/10/21

Release 9 — 6 months, dose 2

2021-08-16

Symptoms: Feel like crap

Release 11 — 6 months, dose 3

2022-05-11

Symptoms: Chronic headache

Release 12 — 3 months, dose 4

2022-09-23

Symptoms: Pain in right side

Release 12 — 6 months, dose 4

2022-12-20

Symptoms: Headache, neck pain,

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	Unevaluable event	✓	✓	✓
SD	Abdominal pain	·	·	✓
SD	Discomfort	✓	✓	✓
SD	Flank pain	·	·	✓
SD	Headache	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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