3QD-78665-18998

3 vaccinations 12 coded responses 40 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 667 / KS
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — day 0, dose 1
MedDRA: Chest discomfort, Flushing — Feeling: Good · Site: Pain, Swelling

Free text: Had little flushing feeling about 7 minutes after shot so stayed an hour at the clinic. Also this afternoon had a couple times I felt little pressure in chest but went away fast.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Hypersomnia, Lymphadenopathy, Pre-existing disease — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Sleeping more than usual. Little headache. but off and on. When I got up I had more swelling in lymph nodes in right underarm and arm. Since I am a breast cancer survivor I had a mammo on March 25 as advice of my breast specialist/surgeon. It is 4:15 pm and the swelling is much better. Since my mastectomy in 1999 and development of lymphedema I am aware of changes. I have an arm compression sleeve I have been using daily before the vaccine. I did not use it yesterday or today since I did not clear it with a doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Lymphoedema, Mastectomy — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: The swelling in the lymph nodes in my right underarm/arm that I reported yesterday is back to normal. I use a compression pump garment daily but have not since the day of the vaccine. I have lymphedema from mastectomy in 1999.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: Just had the shot an hour ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Impaired driving ability, Mobility decreased, Musculoskeletal stiffness — Feeling: Good · Be unable to do your normal daily activities

Free text: Have had stiff neck..hard to turn head from side to side. Had a little all along since last shot. In last few weeks has increased. My husband has had the same happen to him. This affects our driving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Influenza virus test negative, Malaise, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Been sick nearly 6 weeks. Tested for Covid twice and negative. Also tested for flu and RSV. Both negative. Positive for covid antibodies. Have been on three rounds strong antibiotics, and steroids. Also used Advair and Albuteral nebulizer.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-06
Call successful
Participant prefers to complete VAERS report online
2021-12-16
Dose 3 — Moderna
2021-12-16
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-23
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-06
Survey response — day 21, dose 3
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymph nodes feel swollen in arms. And neck

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Survey response — day 28, dose 3
MedDRA: Lymphadenopathy, Neck pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Sore neck Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Survey response — day 35, dose 3
MedDRA: Back pain, Headache, Lymphadenopathy, Neck pain, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Body aches. Sore neck. Swollen lymph nodes off/on. Dull headache. Back pain in lung area.

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Survey response — day 42, dose 3
MedDRA: Fatigue, Lymphadenopathy, Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lymph nodes swollen Tired. Vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-03-17
Survey response — 3 months, dose 3
MedDRA: Colonoscopy abnormal, Condition aggravated, Large intestine polyp, Lymphadenopathy, Office visit, Pre-existing disease, Precancerous lesion of digestive tract — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lymph nodes in armpits and neck and breasts swell off and on. Had recent colonoscopy and EDG. Had 5 precancerous polyps in colon and 1 benign. Have Barrett's Esophagus at GE Junction Varicose veins in my legs have worsened · Healthcare visit (other): Saw specialist

MedDRA releases: 2024-11 · check-in free text available
2022-03-17
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-21
Call successful
Participant prefers to complete VAERS report online
2022-06-16
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-12-16
Survey response — 12 months, dose 3
MedDRA: COVID-19, Chills, Cough, Fatigue, Headache, Productive cough, Pyrexia, Secretion discharge — Feeling: Fair · Be unable to work or attend school, 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: Had Covid after Thanksgiving. Fever chills headache cough mucus phlegm very tired

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-12-16	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-05

Systemic reaction (other): Had little flushing feeling about 7 minutes after shot so stayed an hour at the clinic. Also this afternoon had a couple times I felt little pressure in chest but went away fast.

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Sleeping more than usual. Little headache. but off and on. When I got up I had more swelling in lymph nodes in right underarm and arm. Since I am a breast cancer survivor I had a mammo on March 25 as advice of my breast specialist/surgeon. It is 4:15 pm and the swelling is much better. Since my mastectomy in 1999 and development of lymphedema I am aware of changes. I have an arm compression sleeve I have been using daily before the vaccine. I did not use it yesterday or today since I did not clear it with a doctor.

2021-03-07

Systemic reaction (other): The swelling in the lymph nodes in my right underarm/arm that I reported yesterday is back to normal. I use a compression pump garment daily but have not since the day of the vaccine. I have lymphedema from mastectomy in 1999.

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): Just had the shot an hour ago

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Have had stiff neck..hard to turn head from side to side. Had a little all along since last shot. In last few weeks has increased. My husband has had the same happen to him. This affects our driving.

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: Been sick nearly 6 weeks. Tested for Covid twice and negative. Also tested for flu and RSV. Both negative. Positive for covid antibodies. Have been on three rounds strong antibiotics, and steroids. Also used Advair and Albuteral nebulizer.

Release 10 — day 21, dose 3

2022-01-06

Symptoms: Lymph nodes feel swollen in arms. And neck

Release 10 — day 28, dose 3

2022-01-13

Symptoms: Sore neck Swollen lymph nodes

Release 10 — day 35, dose 3

2022-01-20

Symptoms: Body aches. Sore neck. Swollen lymph nodes off/on. Dull headache. Back pain in lung area.

Release 11 — day 42, dose 3

2022-01-27

Symptoms: Lymph nodes swollen Tired. Vertigo

Release 11 — 3 months, dose 3

2022-03-17

Symptoms: Lymph nodes in armpits and neck and breasts swell off and on. Had recent colonoscopy and EDG. Had 5 precancerous polyps in colon and 1 benign. Have Barrett's Esophagus at GE Junction Varicose veins in my legs have worsened

Healthcare visit (other): Saw specialist

Release 12 — 12 months, dose 3

2022-12-16

Symptoms: Had Covid after Thanksgiving. Fever chills headache cough mucus phlegm very tired

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	·	·	✓
SD	Back pain	·	·	✓
SD	Chills	·	·	✓
SD	Colonoscopy abnormal	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Impaired driving ability	✓	✓	✓
SD	Influenza virus test negative	·	·	✓
SD	Large intestine polyp	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Precancerous lesion of digestive tract	·	·	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 antibody test positive	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Vertigo	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Lymphoedema	✓	✓	✓
SRO	Mastectomy	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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