3J6-17982-79545

2 vaccinations 7 coded responses 10 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 462 / IN
Registered: 2021-08-20

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

2021-07-18
Dose 1 — Moderna
2021-08-15
Dose 2 — Moderna
2021-08-20
Registered in v-safe
2021-08-20
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: swelling at surrounding site significant enough to leave red stretch marks. site swollen to size of 1/2 large orange.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-22
Health check-in — day 7, dose 2
Feeling: Fair · Site: Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-29
Survey response — day 14, dose 2
MedDRA: Heart rate irregular, Lethargy, Oedema peripheral, Respiratory tract congestion, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: HR 153 irreg,02 SATS 92, chest conj. +2 pedal edema, very lethargic. · Healthcare visit (other): Text same info. to Cardiologist. Awaiting response

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-05
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headaches

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-15
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headaches

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-28
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Fatigue, Headache, Oedema, Office visit, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Chest fullness..saw NP and placed on Vancomycin. ...low temp..fatigued and 2+ edema. Headaches continue. .. · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-30
Call 1 — Left Voicemail
2021-11-14
Survey response — 3 months, dose 2
MedDRA: Atrial fibrillation, Dyspnoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: SOB ,a-fib with RVR, currently in Cardiac unit for testing and treatment.

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Report sent to call center — 3 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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-15
Call 1 — Left Voicemail
2021-11-16
Call successful
Participant prefers to complete VAERS report online
2022-02-15
Survey response — 6 months, dose 2
MedDRA: Cardiac ablation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Cardiac ablation on Feb 11 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-02-16
Call 1 — Left Voicemail
2022-02-16
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-18	Moderna	No
2	2021-08-15	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 2

2021-08-20

Systemic reaction (other): swelling at surrounding site significant enough to leave red stretch marks. site swollen to size of 1/2 large orange.

Release 9 — day 14, dose 2

2021-08-29

Symptoms: HR 153 irreg,02 SATS 92, chest conj. +2 pedal edema, very lethargic.

Healthcare visit (other): Text same info. to Cardiologist. Awaiting response

Release 9 — day 21, dose 2

2021-09-05

Symptoms: Headaches

Release 9 — day 28, dose 2

2021-09-15

Symptoms: Headaches

Release 9 — day 42, dose 2

2021-09-28

Symptoms: Chest fullness..saw NP and placed on Vancomycin. ...low temp..fatigued and 2+ edema. Headaches continue. ..

Healthcare visit (other): Office visit

Release 10 — 3 months, dose 2

2021-11-14

Symptoms: SOB ,a-fib with RVR, currently in Cardiac unit for testing and treatment.

Release 11 — 6 months, dose 2

2022-02-15

Symptoms: Cardiac ablation on Feb 11 2022.

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	Office visit	·	·	✓
HCVO	Unevaluable event	✓	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Cardiac ablation	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	·	✓
SD	Heart rate irregular	✓	·	✓
SD	Lethargy	✓	·	✓
SD	Oedema	·	·	✓
SD	Oedema peripheral	✓	·	✓
SD	Office visit	·	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	Unevaluable event	·	·	✓
SRO	Injection site erythema	✓	·	✓
SRO	Injection site swelling	✓	·	✓

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