2AL-21825-37039

3 vaccinations 21 coded responses 37 check-ins 21 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 923 / CA
Registered: 2021-10-07

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-10-07
Registered in v-safe
2021-10-07
Dose 1 — Moderna
2021-10-07
Survey response — day 0, dose 1
MedDRA: Ocular discomfort — Feeling: Fair · Site: Swelling, Itching · Fatigue or tiredness

Free text: Pressure behind eyes

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Dry eyes

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-09
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Headache, Ocular discomfort, Pruritus — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Food tastes different, feel slight pressure in left eye, get get headaches off and on, body feels itchy off and on

MedDRA releases: 2024-11 · check-in free text available
2021-10-10
Survey response — days 1–6 daily, dose 1
MedDRA: Glossitis, Rhinorrhoea, Taste disorder, Throat irritation — Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Free text: Throat feels raw , slight runny nose, tongue feels raw, food doesn't taste right

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Eye irritation, Glossitis, Glossodynia, Ocular discomfort — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Tongue feels raw and hurts a bit, feel a little pressure in my left eye , bth eyes feel dry and scratchy

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Eye irritation, Glossitis, Nasal congestion, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Vomiting, Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: My tongue feels raw, feel a little congested, I feel sore under left arm, eyes still feel scratchy, nose is a bit stuffy and runny

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-14
Survey response — day 7, dose 1
MedDRA: Eye pain, Eye pruritus, Glossitis, Oropharyngeal discomfort, Respiratory tract congestion — Feeling: Poor · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: Tongue still feels a little raw, feel congested, eyes hurt and feel a bit itchy, and my throat still bothers me a bit

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-10-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-11-04
Dose 2 — Moderna
2021-11-04
Survey response — day 0, dose 2
MedDRA: Ear congestion, Eye pruritus, Head discomfort, Nasal congestion, Pain in jaw, Pruritus, Taste disorder — Feeling: Fair · Site: Pain · Joint pains

Free text: Itchy eyes and body, pressure on right temple, right jaw pain, ears and nose congestion, taste is off

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 2
MedDRA: Ear congestion, Ear pain, Nasal congestion, Paranasal sinus discomfort — Feeling: Poor · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ears and nose congestion, slight bilateral ear pain, slight sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Ear discomfort, Ear pain, Injection site erythema, Neck pain, Sinus pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right ear pain, large red spot on my left arm where I got the shot, sinus pain, ears feel stuffy, neck and shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Oedema peripheral, Pain in jaw, Peripheral swelling, Rash, Transient lingual papillitis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Left underarm is swollen received shot on left arm, rash on face along with red spots, right jaw pain, left arm still a little swollen and red near the spot they gave me the shot, small welts on end of tongue

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain, Sinus pain — Feeling: Poor · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Sinus and neck pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — day 7, dose 2
MedDRA: Arthralgia, Eye pruritus, Migraine, Neck pain — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Itchy eyes, migraine, neck and shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-11-25
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-12-02
Survey response — day 28, dose 2
MedDRA: Ageusia, Pain in extremity, Peripheral swelling, Tongue injury, Urticaria — Feeling: Fair

Free text: My hands hurt and feel a little swollen, my sense of taste is still off, and my tongue has small paper like cuts with a few welts like I ate something I shouldn't have.

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-12-16
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-02-03
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-04-04
Dose 3 — Moderna
2022-04-04
Survey response — day 0, dose 3
MedDRA: Eye pruritus, Pruritus — Feeling: Fair

Free text: Itching face and eyes

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-06
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Neck pain, Oedema peripheral, Pain in extremity, Peripheral swelling, Taste disorder — Feeling: Poor · Site: Pain, Swelling, Itching · Joint pains, Fatigue or tiredness

Free text: My left underarm is swollen received injection on left arm. Both biceps feel a little swollen. Pain in shoulders and neck. Food not tasting normal. Hands hurt and feel a bit swollen.

MedDRA releases: 2024-11 · check-in free text available
2022-04-07
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Ear discomfort, Muscle swelling, Neck pain, Oedema peripheral, Pain in extremity, Pain in jaw, Peripheral swelling, Taste disorder — Feeling: Poor · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Biceps feel swollen, left armpit is swollen, pain in shoulders, neck, and hands, hands are a little swollen, jaw pain, ears a bit stuffy, food and drinks don't taste the same

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Dysgeusia, Neck pain, Pain in extremity, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Hands still hurt and feel a little swollen, still have neck and shoulder pain, food and drinks still taste funny

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Axillary pain, Dysgeusia, Neck pain, Oedema peripheral, Pain in extremity, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Food and drinks still taste funny, hands still feel a little swollen and hurt, still have pain in neck and shoulders, left underarm is still a bit swollen and it hurts a bit

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Dysgeusia, Neck pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Food and drinks still taste funny, pain in neck, shoulders, and hands

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Survey response — day 7, dose 3
MedDRA: Arthralgia, Ear congestion, Glossitis, Neck pain, Pruritus, Taste disorder — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Neck and shoulders still hurt, feel itchy off and on, my tongue feels a little raw, food and drinks still not tasting normal, ears are a bit stuffy

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-04-25
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-05-02
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-09
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-05-16
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-07-04
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-10-03
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-04-06
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-07	Moderna	No
2	2021-11-04	Moderna	No
3	2022-04-04	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — day 0, dose 1

2021-10-07

Systemic reaction (other): Pressure behind eyes

Release 10 — days 1–6 daily, dose 1

2021-10-08

Systemic reaction (other): Dry eyes

2021-10-09

Systemic reaction (other): Food tastes different, feel slight pressure in left eye, get get headaches off and on, body feels itchy off and on

2021-10-10

Systemic reaction (other): Throat feels raw , slight runny nose, tongue feels raw, food doesn't taste right

2021-10-11

Systemic reaction (other): Tongue feels raw and hurts a bit, feel a little pressure in my left eye , bth eyes feel dry and scratchy

2021-10-13

Systemic reaction (other): My tongue feels raw, feel a little congested, I feel sore under left arm, eyes still feel scratchy, nose is a bit stuffy and runny

Release 10 — day 7, dose 1

2021-10-14

Systemic reaction (other): Tongue still feels a little raw, feel congested, eyes hurt and feel a bit itchy, and my throat still bothers me a bit

Release 10 — day 0, dose 2

2021-11-04

Systemic reaction (other): Itchy eyes and body, pressure on right temple, right jaw pain, ears and nose congestion, taste is off

Release 10 — days 1–6 daily, dose 2

2021-11-05

Systemic reaction (other): Ears and nose congestion, slight bilateral ear pain, slight sinus pressure

2021-11-06

Systemic reaction (other): Right ear pain, large red spot on my left arm where I got the shot, sinus pain, ears feel stuffy, neck and shoulder pain

2021-11-07

Systemic reaction (other): Left underarm is swollen received shot on left arm, rash on face along with red spots, right jaw pain, left arm still a little swollen and red near the spot they gave me the shot, small welts on end of tongue

2021-11-10

Systemic reaction (other): Sinus and neck pain

Release 10 — day 7, dose 2

2021-11-11

Systemic reaction (other): Itchy eyes, migraine, neck and shoulder pain

Release 10 — day 28, dose 2

2021-12-02

Symptoms: My hands hurt and feel a little swollen, my sense of taste is still off, and my tongue has small paper like cuts with a few welts like I ate something I shouldn't have.

Release 11 — day 0, dose 3

2022-04-04

Systemic reaction (other): Itching face and eyes

Release 11 — days 1–6 daily, dose 3

2022-04-06

Systemic reaction (other): My left underarm is swollen received injection on left arm. Both biceps feel a little swollen. Pain in shoulders and neck. Food not tasting normal. Hands hurt and feel a bit swollen.

2022-04-07

Systemic reaction (other): Biceps feel swollen, left armpit is swollen, pain in shoulders, neck, and hands, hands are a little swollen, jaw pain, ears a bit stuffy, food and drinks don't taste the same

2022-04-08

Systemic reaction (other): Hands still hurt and feel a little swollen, still have neck and shoulder pain, food and drinks still taste funny

2022-04-09

Systemic reaction (other): Food and drinks still taste funny, hands still feel a little swollen and hurt, still have pain in neck and shoulders, left underarm is still a bit swollen and it hurts a bit

2022-04-10

Systemic reaction (other): Food and drinks still taste funny, pain in neck, shoulders, and hands

Release 11 — day 7, dose 3

2022-04-11

Systemic reaction (other): Neck and shoulders still hurt, feel itchy off and on, my tongue feels a little raw, food and drinks still not tasting normal, ears are a bit stuffy

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	Ageusia	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Tongue injury	·	·	✓
SD	Urticaria	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Dry eye	·	·	✓
SRO	Dysgeusia	·	·	✓
SRO	Ear congestion	·	·	✓
SRO	Ear discomfort	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Erythema	·	·	✓
SRO	Eye irritation	·	·	✓
SRO	Eye pain	·	·	✓
SRO	Eye pruritus	·	·	✓
SRO	Glossitis	·	·	✓
SRO	Glossodynia	·	·	✓
SRO	Head discomfort	·	·	✓
SRO	Headache	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Migraine	·	·	✓
SRO	Muscle swelling	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Ocular discomfort	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Oropharyngeal discomfort	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Pain in jaw	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sinus pain	·	·	✓
SRO	Taste disorder	·	·	✓
SRO	Throat irritation	·	·	✓
SRO	Transient lingual papillitis	·	·	✓

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