3DB-18723-18771

1 vaccination 9 coded responses 14 check-ins 9 free-text entries 4 call cases

Sex: —
Age at first dose: 66+
ZIP prefix: 935 / CA
Registered: 2021-01-30

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Survey response — day 0, dose 1
MedDRA: Vasculitis — Feeling: Fair · Site: Pain, Redness

Free text: Blood vessels are enlarged in right hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Erythema — Feeling: Fair · Site: Pain, Redness

Free text: Blood vessels in hands enlarged hands are red & heart pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Site: Redness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Large blood vessels in hand & wrist · Healthcare visit (other): Fam Dr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Vasodilatation — Feeling: Poor · Site: Redness

Free text: Large blood vessels in my hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Vasodilatation — Feeling: Poor

Free text: Enlarged veins in my hand I will see my cardiologist tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Deep vein thrombosis, Medical observation, Office visit, Vasodilatation — Feeling: Fair · Site: Redness · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Went to cardio. Still enlarged veins in my hands · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Survey response — day 7, dose 1
MedDRA: Peripheral swelling — Feeling: Poor · Fever · Headache, Fatigue or tiredness, Abdominal pain

Free text: Blood vessels in my hands still enlarged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-07
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-03-16
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — 3 months, dose 1
Feeling: Poor

Adult check-in
2021-06-14
Call 1 — Left Voicemail
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-07-31
Survey response — 6 months, dose 1
MedDRA: Cardiac pacemaker insertion, Hospitalisation, Loss of consciousness, Vasodilatation — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: I passed out on 5-5-21. I was hospitalized for 2 weeks. Had a pacemaker installed 6-22-21. I still have blood vessels that are visible in my hands & on top of my feet.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-31
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-11
Call 1 — Left Voicemail
2022-01-30
Survey response — 12 months, dose 1
MedDRA: Cerebrovascular accident, Loss of consciousness, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I passed out 5-5-21 had a stroke & then a pacemaker

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna

Call center

4 call center cases

2 successful · 2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-01-30

Systemic reaction (other): Blood vessels are enlarged in right hand

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Blood vessels in hands enlarged hands are red & heart pain

2021-02-01

Systemic reaction (other): Large blood vessels in hand & wrist

Healthcare visit (other): Fam Dr

2021-02-02

Systemic reaction (other): Large blood vessels in my hands

2021-02-03

Systemic reaction (other): Enlarged veins in my hand I will see my cardiologist tomorrow

2021-02-05

Systemic reaction (other): Went to cardio. Still enlarged veins in my hands

Healthcare visit (other): Office visit

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Blood vessels in my hands still enlarged

Release 9 — 6 months, dose 1

2021-07-31

Symptoms: I passed out on 5-5-21. I was hospitalized for 2 weeks. Had a pacemaker installed 6-22-21. I still have blood vessels that are visible in my hands & on top of my feet.

Release 11 — 12 months, dose 1

2022-01-30

Symptoms: I passed out 5-5-21 had a stroke & then a pacemaker

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 observation	✓	✓	○
HCVO	Office visit	✓	✓	✓
SD	Cardiac pacemaker insertion	✓	·	✓
SD	Cerebrovascular accident	·	·	✓
SD	Hospitalisation	✓	·	✓
SD	Loss of consciousness	✓	·	✓
SD	Unevaluable event	·	·	✓
SD	Vasodilatation	✓	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Deep vein thrombosis	✓	✓	○
SRO	Erythema	✓	✓	✓
SRO	Office visit	·	·	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vasculitis	✓	✓	✓
SRO	Vasodilatation	✓	✓	✓

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