38Q-16621-75907

2 vaccinations 8 coded responses 26 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 100 / NY
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Unevaluable event — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Symptoms lessened throughout the day

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 · Site: Redness, Swelling · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Erythema, Joint swelling, Musculoskeletal discomfort, Pruritus — Feeling: Good

Free text: On day 8, my shot shoulder got itchy, red, and swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 21, dose 1
MedDRA: Erythema, Peripheral swelling, Pruritus — Feeling: Good

Free text: Shot arm still a bit red, itchy, swollen. Not serious, just interesting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-20
Health check-in — day 0, dose 2
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Poor · Site: Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Survey response — day 14, dose 2
MedDRA: Erythema, Feeling abnormal, Pruritus, Rash, Urticaria — Feeling: Poor · Be unable to work, 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: 8days after second, huge hives on face, cheeks, eyes, inside nose, buttocks, feeling awful. These subsided, replaced by rash in those places and that spread over arms and thighs, itchy and red. Still there, now 2 weeks after second Moderna

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-20
Survey response — day 28, dose 2
MedDRA: Feeling abnormal, Rash, Swelling face, Urticaria — Feeling: Good

Free text: Eight days after second shot I got a terrible case of hives. My face blew up and there were hives all over my body. I felt awful. The hives began to subside a week or so later but rash continued to spread. The rash still pops up on arms and thighs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 42, dose 2
MedDRA: Rash — Feeling: Good

Free text: Mild Rash reappears on arms face thighs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — 3 months, dose 2
MedDRA: Rash — Feeling: Good

Free text: Bits of rash keep erupting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-02-20
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · 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 around December 15, 2021

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-21
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-20	Moderna

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Symptoms lessened throughout the day

Release 3 — day 14, dose 1

2021-02-05

Symptoms: On day 8, my shot shoulder got itchy, red, and swollen.

Release 4 — day 21, dose 1

2021-02-12

Symptoms: Shot arm still a bit red, itchy, swollen. Not serious, just interesting.

Release 5 — day 14, dose 2

2021-03-06

Symptoms: 8days after second, huge hives on face, cheeks, eyes, inside nose, buttocks, feeling awful. These subsided, replaced by rash in those places and that spread over arms and thighs, itchy and red. Still there, now 2 weeks after second Moderna

Release 6 — day 28, dose 2

2021-03-20

Symptoms: Eight days after second shot I got a terrible case of hives. My face blew up and there were hives all over my body. I felt awful. The hives began to subside a week or so later but rash continued to spread. The rash still pops up on arms and thighs

Release 6 — day 42, dose 2

2021-04-03

Symptoms: Mild Rash reappears on arms face thighs

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: Bits of rash keep erupting

Release 11 — 12 months, dose 2

2022-02-20

Symptoms: Covid around December 15, 2021

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	Erythema	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Musculoskeletal discomfort	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Swelling face	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Unevaluable event	✓	✓	○

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