2AZ-16593-17067

4 vaccinations 4 coded responses 34 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 482 / MI
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Health check-in — day 0, dose 1
Feeling: Good · Site: Swelling · Muscle or body aches

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: I had a metallic taste in my mouth yesterday afternoon. My pain today is deep in my arm, still surrounding the vaccination site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Diarrhea

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — day 35, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: I have random, very minimal pain in my vaccine arm. I get weekly allergy shots in both arms and sometimes that arm hurts more than usual. Nothing serious though.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Pfizer-BioNTech
2022-04-06
Survey response — 12 months, dose 2
MedDRA: Emergency care, Joint swelling, Respiratory tract infection, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: My ankle swelled up badly enough that I went to the ER. No apparent cause. I've also had two respiratory illnesses that were quite severe but I tested negative for Covid. All are probably unrelated to the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-11
Call 1 — Left Voicemail
2022-04-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-15
Dose 4 — Moderna
Co-administered: Shingles
2022-04-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-15
Survey response — 3 months, dose 4
MedDRA: COVID-19, Sinus congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid 19 with stuffiness in my sinuses.

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-19
Call 1 — Left Voicemail
2022-07-19
Call successful
Participant prefers to complete VAERS report online
2022-10-14
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-17
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-10-28	Pfizer-BioNTech	No
4	2022-04-15	Moderna	Shingles

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): I had a metallic taste in my mouth yesterday afternoon. My pain today is deep in my arm, still surrounding the vaccination site.

Release 8 — day 35, dose 2

2021-05-11

Symptoms: I have random, very minimal pain in my vaccine arm. I get weekly allergy shots in both arms and sometimes that arm hurts more than usual. Nothing serious though.

Release 11 — 12 months, dose 2

2022-04-06

Symptoms: My ankle swelled up badly enough that I went to the ER. No apparent cause. I've also had two respiratory illnesses that were quite severe but I tested negative for Covid. All are probably unrelated to the vaccine.

Release 12 — 3 months, dose 4

2022-07-15

Symptoms: Covid 19 with stuffiness in my sinuses.

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	COVID-19	·	·	✓
SD	Emergency care	·	·	✓
SD	Joint swelling	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract infection	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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