4D5-21705-39940

3 vaccinations 7 coded responses 26 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 120 / NY
Registered: 2021-03-26

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

2021-03-25
Dose 1 — Moderna
2021-03-26
Registered in v-safe
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-08
Survey response — day 14, dose 1
MedDRA: Erythema, Fatigue, Hypersomnia, Induration, Pain, Pruritus, Rash, Skin warm — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: On evening of day 8 after vaccination I got a full blown rebound rash on my arm. Red itchy hard and hot to touch. Painful to move. Also completely exhausted. Slept for 10 hours. Then felt drained but ok next day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-22
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tinnitus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness, nearly passed out. Ringing in ears.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Ringing in my ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-29
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Dizziness in the morning. Fine by noon time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 14, dose 2
MedDRA: Oedema peripheral, Rash — Feeling: Good

Free text: Swelling under my arm. Armpit of the arm I was vaccinated. Different arm than first dose. I switched sides because I got a rash on that side on day 8. Still all worth it!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-02
Dose 3 — Moderna
2022-04-22
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, Office visit, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Head cold, heart palpitations. · Healthcare visit (other): Primary care doctor

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-25
Call successful
Does not wish to fill out VAERS report
2022-12-02
Survey response — 12 months, dose 3
MedDRA: COVID-19, Fatigue, Inflammation — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit

Free text: COVID diagnosis with lingering fatigue and inflammation.

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna
3	2021-12-02	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-08

Symptoms: On evening of day 8 after vaccination I got a full blown rebound rash on my arm. Red itchy hard and hot to touch. Painful to move. Also completely exhausted. Slept for 10 hours. Then felt drained but ok next day.

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Dizziness, nearly passed out. Ringing in ears.

2021-04-24

Systemic reaction (other): Ringing in my ears

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): Dizziness in the morning. Fine by noon time.

Release 8 — day 14, dose 2

2021-05-06

Symptoms: Swelling under my arm. Armpit of the arm I was vaccinated. Different arm than first dose. I switched sides because I got a rash on that side on day 8. Still all worth it!

Release 11 — 12 months, dose 2

2022-04-22

Symptoms: Head cold, heart palpitations.

Healthcare visit (other): Primary care doctor

Release 12 — 12 months, dose 3

2022-12-02

Symptoms: COVID diagnosis with lingering fatigue and inflammation.

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	COVID-19	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Inflammation	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oedema peripheral	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Skin warm	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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