4PC-13579-07410

2 vaccinations 9 coded responses 25 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 852 / AZ
Registered: 2021-03-01

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

2021-03-01
Registered in v-safe
2021-03-01
Dose 1 — Moderna
2021-03-01
Survey response — day 0, dose 1
MedDRA: Flushing, Swelling face — Feeling: Good · Site: Pain

Free text: My face feels a tiny bit flushed and feels tiny bit puffy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Headache — Feeling: Good · Site: Pain, Redness · Headache

Free text: Just a fuzzy pressure low grade headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Survey response — day 7, dose 1
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Slight rash on check that has not gone away yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site rash, Rash pruritic — Feeling: Good

Free text: Rash developed on vaccine arm about 10 days after shot. Very itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: Nausea — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Free text: Felt a tiny bit nauseous. But not too bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Headache, Malaise, Nausea — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Just feel really crappy. Bad headache and nauseous. Chills nausea was no so good last night. Hoping I feel better tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Fatigue or tiredness

Free text: Sad to see another rash and swelling now in my right arm. Ugh!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-10
Survey response — day 7, dose 2
MedDRA: Malaise — Feeling: Good · Site: Redness, Itching

Free text: Feel like Im coming down with a repertory infection. Could be just allergies. If not better by Monday going to see my doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 42, dose 2
MedDRA: Blood alkaline phosphatase increased, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Alkaline Phosphatase jumped 31 points out of normal range from last well check from March 2021. Seeing my dr on Monday May 14 to be retested. · Healthcare visit (other): Going to see dr on May 14 to do lab work and retest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-18
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-04-02	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-03-01

Systemic reaction (other): My face feels a tiny bit flushed and feels tiny bit puffy

Release 4 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Just a fuzzy pressure low grade headache

Release 5 — day 7, dose 1

2021-03-08

Systemic reaction (other): Slight rash on check that has not gone away yet.

Release 5 — day 14, dose 1

2021-03-15

Symptoms: Rash developed on vaccine arm about 10 days after shot. Very itchy.

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): Felt a tiny bit nauseous. But not too bad.

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Just feel really crappy. Bad headache and nauseous. Chills nausea was no so good last night. Hoping I feel better tomorrow

2021-04-04

Systemic reaction (other): Sad to see another rash and swelling now in my right arm. Ugh!

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): Feel like Im coming down with a repertory infection. Could be just allergies. If not better by Monday going to see my doctor.

Release 8 — day 42, dose 2

2021-05-14

Symptoms: Alkaline Phosphatase jumped 31 points out of normal range from last well check from March 2021. Seeing my dr on Monday May 14 to be retested.

Healthcare visit (other): Going to see dr on May 14 to do lab work and retest.

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	Unevaluable event	✓	✓	✓
SD	Blood alkaline phosphatase increased	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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