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3YA-12081-54619

2 vaccinations 10 coded responses 12 check-ins 10 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
064 / CT
Registered
2021-02-05
Relationship
Self
Race
N/A
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-04
    Dose 1 — Moderna
  2. 2021-02-05
    Registered in v-safe
  3. 2021-02-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Blood glucose decreased — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities
    Free text: My sugar level was very low today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · None
    Adult check-in
  5. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-25
    Survey response — day 21, dose 1
    MedDRA: Abdominal discomfort, Asthenia, Nausea — Feeling: Poor · Be unable to do your normal daily activities
    Free text: I had little energy, upset stomach and nausea.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-04
    Dose 2 — Moderna
  8. 2021-03-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Paraesthesia — Feeling: Poor · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Felt like pins and needles attacking my lower legs.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lip swelling — Feeling: Poor · Site: Swelling · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: My lips are swollen. I took a pic to save in my phone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lip swelling — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Swollen lips
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-09
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased, Cerebrovascular accident, Lip swelling — Feeling: Fair · Site: Redness · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: I had swollen lips and was prescribed 50mg prednisone, my glucose level went to 384. Felt like I was having a stroke.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-09
    Report sent to call center — days 1–6 daily, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-03-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lip swelling — Feeling: Fair · Fatigue or tiredness
    Free text: Lips still swollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-11
    Survey response — day 7, dose 2
    MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness
    Free text: Just light headed.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-18
    Survey response — day 14, dose 2
    MedDRA: Blood glucose increased, Breast swelling, Lip swelling — Feeling: Good · Be unable to do your normal daily activities
    Free text: Swelling on the side of my right breast and lips swelled up again, also increase in my glucose level.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-28
    Survey response — day 21, dose 2
    MedDRA: Peripheral swelling — Feeling: Good
    Free text: Swollen fingers
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-11-20
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-02-04Moderna
22021-03-04Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): My sugar level was very low today

Release 4 — day 21, dose 1

2021-02-25

Symptoms: I had little energy, upset stomach and nausea.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Felt like pins and needles attacking my lower legs.

2021-03-07

Systemic reaction (other): My lips are swollen. I took a pic to save in my phone.

2021-03-08

Systemic reaction (other): Swollen lips

2021-03-09

Systemic reaction (other): I had swollen lips and was prescribed 50mg prednisone, my glucose level went to 384. Felt like I was having a stroke.

2021-03-10

Systemic reaction (other): Lips still swollen

Release 5 — day 7, dose 2

2021-03-11

Systemic reaction (other): Just light headed.

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Swelling on the side of my right breast and lips swelled up again, also increase in my glucose level.

Release 6 — day 21, dose 2

2021-03-28

Symptoms: Swollen fingers

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

FieldPreferred term2021-092023-042024-11
SDAbdominal discomfort ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDBlood glucose increased ✓ ✓ ✓
SDBreast swelling ✓ ✓ ✓
SDLip swelling ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDPeripheral swelling ✓ ✓ ✓
SROBlood glucose decreased ✓ ✓ ✓
SROBlood glucose increased ✓ ✓ ✓
SROCerebrovascular accident ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROLip swelling ✓ ✓ ✓
SROParaesthesia ✓ ✓ ✓

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

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