2R9-16708-27002

3 vaccinations 14 coded responses 34 check-ins 14 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 070 / NJ
Registered: 2021-01-18

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Moderna
2021-01-18
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — day 0, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-20
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia, Peripheral swelling — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Insomnia for two nights (which is atypical) and my hands swelled for two days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Injection site swelling, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain · Joint pains

Free text: Hand pain/swelling reducing; also noticed armpit on side of injection site is quite swollen/tender, did notice earlier that it hurt to put on deodorant but didnt visually check/touch until today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Peripheral swelling — Feeling: Good

Free text: Swelling in hands also gone as of yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-01-25
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Hands swollen around joints

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary mass, Lymph node pain, Lymphadenopathy, Lymphocele, Peripheral swelling, Tenderness — Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymphatic tissue under left/injection arm swollen and tender, hand swelling reducing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Gland under armpit on injection side swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Injection site scab — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness

Free text: Lymphatic tissue under injection site arm swollen and painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache, Neck pain, Odynophagia, Pain — Feeling: Fair

Free text: Headache for two days (very atypical for me), overly tired, and pain in neck glands without swelling (hurts to move neck and swallow). Thought maybe the vaccine since very atypical.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Chest pain, Epistaxis, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headache, chest pain, bloody nose, and BP elevated (130/96).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — 3 months, dose 2
MedDRA: Amenorrhoea, Haemorrhoids thrombosed, Hot flush, Lymphadenopathy, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Havent had a menstrual cycle since a February (and having hot flashes); swelling in lymph nodes (under arm, elbows); thrombosed hemorrhoids (2) and never had hemorrhoids prior

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-30
Call 1 — Left Voicemail
2021-08-17
Survey response — 6 months, dose 2
MedDRA: Cyst, Hot flush, Menstruation irregular, Office visit, Papule — Feeling: Good

Free text: Menstrual cycle stopped for 3 mos after 2nd vaccine in mid-Feb (no cycle following in Mar, April, May, until mid-June) and had hot flashes during that time; also have a new cyst on my mid-back (non-erythematous cystic papule per dermatologist)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-22
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Medical counselling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Emailed Dr image of arm and asked for advice on treatment (ice, Advil, Benadryl, etc)

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-10-27
Call successful
Participant prefers to complete VAERS report online
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
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: Body temperature increased, Fatigue, Nasal congestion, Office visit, Sinus headache — Feeling: Fair

Free text: Very tired, mildly stuffy nose, sinus headache, low fever 99.6. Received flu shot 11/22/21, so possibly delayed side effects. Dr aware, just monitoring, resting, and staying home.

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

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Alopecia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Hair loss for the last six months · Healthcare visit (other): In person visit scheduled for Feb

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-24
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Moderna
2	2021-02-15	Moderna
3	2021-10-22	Moderna	No

Call center

4 call center cases

3 successful · 1 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-20

Systemic reaction (other): Insomnia for two nights (which is atypical) and my hands swelled for two days

2021-01-21

Systemic reaction (other): Hand pain/swelling reducing; also noticed armpit on side of injection site is quite swollen/tender, did notice earlier that it hurt to put on deodorant but didnt visually check/touch until today.

2021-01-23

Systemic reaction (other): Swelling in hands also gone as of yesterday

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): Hands swollen around joints

2021-02-17

Systemic reaction (other): Lymphatic tissue under left/injection arm swollen and tender, hand swelling reducing

2021-02-18

Systemic reaction (other): Gland under armpit on injection side swollen

2021-02-19

Systemic reaction (other): Lymphatic tissue under injection site arm swollen and painful

Release 4 — day 14, dose 2

2021-03-01

Symptoms: Headache for two days (very atypical for me), overly tired, and pain in neck glands without swelling (hurts to move neck and swallow). Thought maybe the vaccine since very atypical.

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Headache, chest pain, bloody nose, and BP elevated (130/96).

Release 8 — 3 months, dose 2

2021-05-17

Symptoms: Havent had a menstrual cycle since a February (and having hot flashes); swelling in lymph nodes (under arm, elbows); thrombosed hemorrhoids (2) and never had hemorrhoids prior

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Menstrual cycle stopped for 3 mos after 2nd vaccine in mid-Feb (no cycle following in Mar, April, May, until mid-June) and had hot flashes during that time; also have a new cyst on my mid-back (non-erythematous cystic papule per dermatologist)

Release 10 — days 1–6 daily, dose 3

2021-10-26

Healthcare visit (other): Emailed Dr image of arm and asked for advice on treatment (ice, Advil, Benadryl, etc)

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Very tired, mildly stuffy nose, sinus headache, low fever 99.6. Received flu shot 11/22/21, so possibly delayed side effects. Dr aware, just monitoring, resting, and staying home.

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Hair loss for the last six months

Healthcare visit (other): In person visit scheduled for Feb

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Alopecia	·	·	✓
SD	Amenorrhoea	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Body temperature increased	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Cyst	✓	·	✓
SD	Epistaxis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Haemorrhoids thrombosed	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Menstruation irregular	✓	·	✓
SD	Nasal congestion	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Odynophagia	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Pain	✓	✓	✓
SD	Papule	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus headache	·	·	✓
SRO	Axillary mass	○	✓	○
SRO	Injection site pain	✓	✓	✓
SRO	Injection site scab	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Lymphocele	○	✓	○
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Tenderness	○	✓	○

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