473-13355-27516

4 vaccinations 7 coded responses 34 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 019 / MA
Registered: 2021-02-27

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

2021-02-24
Dose 1 — Moderna
2021-02-27
Registered in v-safe
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Rash papular, Vaccination site erythema, Vaccination site pruritus, Vaccination site rash, Vaccination site reaction, Vaccination site warmth — Feeling: Good

Free text: CovidArm rash near vaccination site. Two small patches surfaced on day nine. Red, hot and slightly raised. Some itching. One patch resolved day 12. Second patch much lighter and resolving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 21, dose 1
MedDRA: Immunisation reaction, Rash, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection. Ive had them in the past. On antibiotics and prednisone. My covid arm rash gone except for slight pinkish area, not hot, raised or itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Dose 2 — Moderna
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

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

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

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

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Fatigue, Headache, Pain, Pyrexia — Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Free text: My shot was October 25, 2021. Following day I had chills, fever, fatigue, aches, and headache,

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Survey response — day 28, dose 3
MedDRA: Gastroenteritis viral — Feeling: Fair

Free text: Stomach bug . Maybe flu? Had booster and flu shot though.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-26
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-07
Dose 4 — Moderna
2022-04-18
Survey response — day 7, dose 4
MedDRA: Adverse reaction — Feeling: Good · Site: Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Symptoms lasted for 3 days after 4th booster

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-07
Survey response — 3 months, dose 4
MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection. Covid negative 3 times. Plane trip to (b)(6) with n95 and 2 restaurants without mask.

MedDRA releases: 2024-11 · check-in free text available
2022-07-07
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-06
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-07
Survey response — 12 months, dose 4
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-07
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-10
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-31	Moderna
3	2021-10-25	Moderna	No
4	2022-04-07	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-10

Symptoms: CovidArm rash near vaccination site. Two small patches surfaced on day nine. Red, hot and slightly raised. Some itching. One patch resolved day 12. Second patch much lighter and resolving.

Release 5 — day 21, dose 1

2021-03-17

Symptoms: Sinus infection. Ive had them in the past. On antibiotics and prednisone. My covid arm rash gone except for slight pinkish area, not hot, raised or itchy.

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): My shot was October 25, 2021. Following day I had chills, fever, fatigue, aches, and headache,

Release 10 — day 28, dose 3

2021-11-22

Symptoms: Stomach bug . Maybe flu? Had booster and flu shot though.

Release 11 — day 7, dose 4

2022-04-18

Systemic reaction (other): Symptoms lasted for 3 days after 4th booster

Release 12 — 3 months, dose 4

2022-07-07

Symptoms: Sinus infection. Covid negative 3 times. Plane trip to (b)(6) with n95 and 2 restaurants without mask.

redacted (b)(6)

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
SD	COVID-19	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Immunisation reaction	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash papular	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Vaccination site erythema	✓	✓	✓
SD	Vaccination site pruritus	✓	✓	✓
SD	Vaccination site rash	✓	✓	✓
SD	Vaccination site reaction	✓	✓	✓
SD	Vaccination site warmth	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Chills	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	·	·	✓

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