3QY-27590-57758

3 vaccinations 4 coded responses 38 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 604 / IL
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Erythema, Fatigue, Feeling hot, Inflammation, Peripheral swelling — Feeling: Fair

Free text: My arm began to swell where I had the vaccination last Saturday and continued to swell for over 24 hrs (red, inflammed and warm to the touch). Swelling began to go down within about 48 hrs and redness was gone within 72 yrs. Still have fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Rash erythematous, Skin warm — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hot red rash on arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-11
Dose 3 — Moderna
2022-01-11
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-14
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Burning sensation, Erythema, Pain in extremity, Unevaluable event, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): My entire arm from shoulder to elbow is a fiery red welt. Very painful. · Healthcare visit (other): Getting ready to go for a visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-15
Survey response — days 1–6 daily, dose 3
MedDRA: Inflammation, Peripheral swelling, Rash — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash on arm has spread..from deltoid to elbow. All sides of arm inflammed and swollen.

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-01-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-01-18
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Headache

Adult check-in
2022-01-18
Call 1 — Left Voicemail
2022-01-18
Call successful
Participant prefers to complete VAERS report online
2022-01-25
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-02-01
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-02-08
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-15
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-12
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-12
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-01-11
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2022-01-11	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-21

Symptoms: My arm began to swell where I had the vaccination last Saturday and continued to swell for over 24 hrs (red, inflammed and warm to the touch). Swelling began to go down within about 48 hrs and redness was gone within 72 yrs. Still have fatigue.

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Hot red rash on arm

Release 10 — days 1–6 daily, dose 3

2022-01-14

Systemic reaction (other): My entire arm from shoulder to elbow is a fiery red welt. Very painful.

Healthcare visit (other): Getting ready to go for a visit

2022-01-15

Systemic reaction (other): Rash on arm has spread..from deltoid to elbow. All sides of arm inflammed and swollen.

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	Unevaluable event	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Burning sensation	·	·	✓
SRO	Erythema	·	·	✓
SRO	Inflammation	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Rash	·	·	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Skin warm	✓	✓	✓
SRO	Urticaria	·	·	✓

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