2V5-11287-53176

1 vaccination 5 coded responses 15 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 775 / TX
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Slightly dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site vesicles, Office visit — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): 5 Small blisters on on injection arm · Healthcare visit (other): Allergist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · Headache, Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-01-21
Survey response — day 7, dose 1
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Pain under arm at lymph node

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — day 14, dose 1
MedDRA: Anaphylactic reaction, Erythema, Injection site discharge, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Peripheral swelling, Pruritus, Skin warm — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Worsening redness, pain and swelling at and around injection sire. Spreading to new tissue in an extremely large a long circle. Hot to touch and accompanied by thick copious secretions. · Healthcare visit (other): Received epi/steroids and high dose antihistamines. After 14 days the red raised hot itchy circle to my arm continues to grow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-03-19
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-04-15
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2022-01-14
Survey response — 12 months, dose 1
MedDRA: Antimitochondrial antibody positive, Hepatitis acute, Liver injury, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Liver injury- under medical evaluation for COVID vaccine drug induced liver injury. Acute autoimmune-like hepatitis with atypical anti mitochondrial antibody after MRNA vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-17
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-14

Systemic reaction (other): Slightly dizzy

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): 5 Small blisters on on injection arm

Healthcare visit (other): Allergist

Release 2 — day 7, dose 1

2021-01-21

Systemic reaction (other): Pain under arm at lymph node

Release 2 — day 14, dose 1

2021-01-28

Symptoms: Worsening redness, pain and swelling at and around injection sire. Spreading to new tissue in an extremely large a long circle. Hot to touch and accompanied by thick copious secretions.

Healthcare visit (other): Received epi/steroids and high dose antihistamines. After 14 days the red raised hot itchy circle to my arm continues to grow.

Release 10 — 12 months, dose 1

2022-01-14

Symptoms: Liver injury- under medical evaluation for COVID vaccine drug induced liver injury. Acute autoimmune-like hepatitis with atypical anti mitochondrial antibody after MRNA vaccine.

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	Anaphylactic reaction	✓	✓	✓
HCVO	Erythema	✓	✓	✓
HCVO	Injection site erythema	○	○	○
HCVO	Injection site pruritus	○	○	○
HCVO	Injection site warmth	○	○	○
HCVO	Office visit	✓	✓	✓
HCVO	Peripheral swelling	✓	✓	✓
HCVO	Pruritus	✓	✓	✓
HCVO	Skin warm	✓	✓	✓
SD	Antimitochondrial antibody positive	·	·	✓
SD	Erythema	○	○	○
SD	Hepatitis acute	·	·	✓
SD	Injection site discharge	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Liver injury	·	·	✓
SD	Medical counselling	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site vesicles	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓

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