228-32486-62098

3 vaccinations 12 coded responses 36 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 957 / CA
Registered: 2021-01-15

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: I had trouble sleeping the first night, better last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Diarrhea

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

Adult check-in
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Muscle or body aches

Free text: I have a small, painful, swollen lymph node in my left superficial cervical area. I was vaccinated in my left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Muscle or body aches

Free text: Lymph node still mildly enlarged/painful but improved from yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperaesthesia, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Hyperesthesia (skin burned/hurt to the touch); lymphadenopathy left prescapular node; painful node.

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: Lymphadenopathy — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Free text: Lymph node still swollen on neck, painful (mildly)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Lip blister, Oropharyngeal blistering, Oropharyngeal pain, Pain, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had very sore throat x 8 days with blisters in oropharynx and inner lips (moist mucosa). Very painful. No fever. No cough or upper airway symptoms. At home Covid antigen test negative x 2, 48 hrs apart.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-22
Dose 3 — Moderna
Co-administered: Flu
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Dermal filler reaction, Injection site pain, Lymph node pain, Lymphadenopathy, Periorbital swelling, Swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Swelling under one eye and on chin (previously received'fillers' there , in April 2021. Also, pain and swelling of lymph nodes (under arm, on clavicle and neck, side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy, Oedema, Periorbital pain, Periorbital swelling, Swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches · Be unable to do your normal daily activities

Free text: Swelling/edema and lymph node enlargement, axillary region same side as injection. Also along neck. Under eye swelling still present but no longer painful.

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Intermenstrual bleeding — Feeling: Good · Site: Pain

Free text: Menstrual spotting

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — day 7, dose 3
MedDRA: Intermenstrual bleeding — Feeling: Good

Free text: Menstrual spotting

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 35, dose 3
MedDRA: Nasal congestion, Throat irritation — Feeling: Fair

Free text: Mild scratchy throat, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-07
Call successful
Participant prefers to complete VAERS report online
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-24
Survey response — 12 months, dose 3
MedDRA: Arthropathy, Bursitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Joint issues. Olecranon bursitis

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-11	Moderna
3	2021-10-22	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): I had trouble sleeping the first night, better last night

2021-01-21

Systemic reaction (other): I have a small, painful, swollen lymph node in my left superficial cervical area. I was vaccinated in my left arm.

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Lymph node still mildly enlarged/painful but improved from yesterday

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Hyperesthesia (skin burned/hurt to the touch); lymphadenopathy left prescapular node; painful node.

2021-02-13

Systemic reaction (other): Lymph node still swollen on neck, painful (mildly)

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Had very sore throat x 8 days with blisters in oropharynx and inner lips (moist mucosa). Very painful. No fever. No cough or upper airway symptoms. At home Covid antigen test negative x 2, 48 hrs apart.

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Swelling under one eye and on chin (previously received'fillers' there , in April 2021. Also, pain and swelling of lymph nodes (under arm, on clavicle and neck, side of injection

2021-10-25

Systemic reaction (other): Swelling/edema and lymph node enlargement, axillary region same side as injection. Also along neck. Under eye swelling still present but no longer painful.

2021-10-28

Systemic reaction (other): Menstrual spotting

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): Menstrual spotting

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Mild scratchy throat, nasal congestion

Release 12 — 12 months, dose 3

2022-10-24

Symptoms: Joint issues. Olecranon bursitis

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	Arthropathy	·	·	✓
SD	Bursitis	·	·	✓
SD	Lip blister	✓	·	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal blistering	✓	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pain	✓	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Throat irritation	·	·	✓
SRO	Dermal filler reaction	·	·	✓
SRO	Hyperaesthesia	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Intermenstrual bleeding	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oedema	·	·	✓
SRO	Periorbital pain	·	·	✓
SRO	Periorbital swelling	·	·	✓
SRO	Swelling	·	·	✓

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