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4LU-21766-55428

3 vaccinations 4 coded responses 13 check-ins 4 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
151 / PA
Registered
2021-03-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-04
    Dose 1 — Moderna
  2. 2021-03-13
    Registered in v-safe
  3. 2021-03-13
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  4. 2021-03-18
    Survey response — day 14, dose 1
    MedDRA: Erythema, Fatigue, Immunisation reaction, Pain, Pruritus — 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
    Free text: Covid-arm symptoms spread down my arm to the elbow and around the front of the muscle and to the back. Extreme itchiness, fatigue and body aches. Started letting up yesterday. Arm still red. Steroid cream,& Benedryl
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-18
    Report sent to call center — day 14, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-03-26
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-04-01
    Dose 2 — Moderna
  8. 2021-04-15
    Survey response — day 14, dose 2
    MedDRA: Erythema, Peripheral swelling, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Red itchy swollen upper arm · Healthcare visit (other): Used medication from a previous visit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-15
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-04-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-04-29
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-05-07
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-05-15
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-07-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-10-01
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-11-05
    Dose 3 — Moderna
    Co-administered: Flu
  17. 2022-01-20
    Call successful
    Participant prefers to complete VAERS report online
  18. 2022-04-01
    Survey response — 12 months, dose 2
    MedDRA: Impaired work ability, Laryngitis, Nasopharyngitis, Speech disorder — Feeling: Good · Be unable to do your normal daily activities
    Free text: Had a cold and laryngitis in February. Couldn't talk. So couldn't do my job
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-05-06
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  20. 2022-11-05
    Survey response — 12 months, dose 3
    MedDRA: Anaemia, Hiatus hernia, Pulmonary embolism — Feeling: Fair · 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, Emergency room or emergency department visit, Hospitalization
    Free text: Giant hiatel hernia,extreme anemia, pulmonary embolisms
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-11-05
    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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  22. 2022-11-08
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna
32021-11-05Moderna Flu

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-18

Symptoms: Covid-arm symptoms spread down my arm to the elbow and around the front of the muscle and to the back. Extreme itchiness, fatigue and body aches. Started letting up yesterday. Arm still red. Steroid cream,& Benedryl

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Red itchy swollen upper arm
Healthcare visit (other): Used medication from a previous visit

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Had a cold and laryngitis in February. Couldn't talk. So couldn't do my job

Release 12 — 12 months, dose 3

2022-11-05

Symptoms: Giant hiatel hernia,extreme anemia, pulmonary embolisms

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
HCVOSelf-medication ✓ ✓ ✓
SDAnaemia · · ✓
SDErythema ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHiatus hernia · · ✓
SDImmunisation reaction ✓ ✓ ✓
SDImpaired work ability · · ✓
SDLaryngitis · · ✓
SDNasopharyngitis · · ✓
SDPain ✓ ✓ ✓
SDPeripheral swelling ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDPulmonary embolism · · ✓
SDSpeech disorder · · ✓

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