4HK-13518-90154

3 vaccinations 9 coded responses 24 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 981 / WA
Registered: 2021-01-10

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

2021-01-08
Dose 1 — Moderna
2021-01-10
Registered in v-safe
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Erythema, Induration, Injection site swelling, Pruritus — Feeling: Fair

Free text: Developed 6x10cm area (surrounding injection site) of intense pruritus, erythema and induration starting day 7 post vaccination through day 11. Still with some lingering pruritus in same area. VERY CONCERNED ABOUT SECOND DOSE. Would like a call back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 21, dose 1
MedDRA: Injection site erythema, Injection site induration, Injection site pruritus, Oral herpes, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe herpetic outbreak on lip one day after developing the erythematous, indurated, pruritic area surround my injection site. Also had possible early signs of a Bells Palsy. Treated with Valtrex for one week. I am a physician. · Healthcare visit (other): Self- I am a physician (MD)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Anuria, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: No urine output for ~10 hrs despite rigorous hydration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — day 7, dose 2
MedDRA: Injection site induration — Feeling: Good · Site: Swelling

Free text: Forgot to previously mention the induration surrounding my injection site, without erythema , from day 2-6, which is currently resolved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 14, dose 2
MedDRA: Contusion — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Unusual extreme bruising lower extremities (mid calves to ankles) after low impact cross country skiing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Low grade fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-14
Survey response — day 35, dose 2
MedDRA: Contusion — Feeling: Good

Free text: Still getting some unusual bruises on legs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — day 42, dose 2
MedDRA: Contusion, Fatigue — Feeling: Good

Free text: Still some unusual bruising and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Call 1 — Left Voicemail
2021-11-19
Dose 3 — Moderna
2022-02-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-20
Survey response — 6 months, dose 3
MedDRA: Muscle injury — Feeling: Poor · Be unable to work or attend school, 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: Avulsed L hamstring in March2022 while engaged in low impact activity. Other connective tissues issues as well.

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — 6 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-23
Call successful
Participant prefers to complete VAERS report online
2022-05-23
Call successful
Participant prefers to complete VAERS report online
2022-05-23
Call successful
Participant prefers to complete VAERS report online
2022-05-23
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-11-19	Moderna	No

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Developed 6x10cm area (surrounding injection site) of intense pruritus, erythema and induration starting day 7 post vaccination through day 11. Still with some lingering pruritus in same area. VERY CONCERNED ABOUT SECOND DOSE. Would like a call back. cut off by CDC

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Severe herpetic outbreak on lip one day after developing the erythematous, indurated, pruritic area surround my injection site. Also had possible early signs of a Bells Palsy. Treated with Valtrex for one week. I am a physician.

Healthcare visit (other): Self- I am a physician (MD)

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): No urine output for ~10 hrs despite rigorous hydration

Release 4 — day 7, dose 2

2021-02-14

Systemic reaction (other): Forgot to previously mention the induration surrounding my injection site, without erythema , from day 2-6, which is currently resolved

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Unusual extreme bruising lower extremities (mid calves to ankles) after low impact cross country skiing.

Release 4 — day 21, dose 2

2021-02-27

Symptoms: Low grade fatigue.

Release 5 — day 35, dose 2

2021-03-14

Symptoms: Still getting some unusual bruises on legs.

Release 6 — day 42, dose 2

2021-03-21

Symptoms: Still some unusual bruising and fatigue.

Release 11 — 6 months, dose 3

2022-05-20

Symptoms: Avulsed L hamstring in March2022 while engaged in low impact activity. Other connective tissues issues as well.

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	Self-medication	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site induration	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Muscle injury	·	·	✓
SD	Oral herpes	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Anuria	✓	·	✓
SRO	Injection site induration	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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