54S-22257-97916

3 vaccinations 10 coded responses 36 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 857 / AZ
Registered: 2021-02-04

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Paraesthesia oral — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: I did have a metallic taste in my mouth after the vaccine on Thursday, lasted for a few hours. As well as tingly gums the first day,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Tremor — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Just feel off and at times a little shaky.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: Foggy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Lip swelling, Paraesthesia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Face feels tingly and lips feel a little swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Nasopharyngitis, Paraesthesia — Feeling: Poor · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tingling, cold arm on same size as the injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling jittery — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Slight dizziness this morning, just feel kind of jittery and dazed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling jittery, Lymphadenopathy — Feeling: Good · Headache

Free text: Swollen lymph nodes in neck and feeling short of jittery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Fatigue or tiredness

Free text: Bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 7, dose 2
MedDRA: Peripheral coldness — Feeling: Good · Headache

Free text: Arm & hand feel cold on right side, same side as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 21, dose 2
MedDRA: Heart rate increased, Peripheral coldness, Tremor — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Shaky and fast heart beat. Also right hand gets cold, same side as injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-02
Dose 3 — Moderna
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea, Vomiting

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-12-09
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-12-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-02
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-02
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-03-25	Successful 2021-11-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): I did have a metallic taste in my mouth after the vaccine on Thursday, lasted for a few hours. As well as tingly gums the first day,

2021-02-07

Systemic reaction (other): Just feel off and at times a little shaky.

2021-02-09

Systemic reaction (other): Foggy

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): Face feels tingly and lips feel a little swollen

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Tingling, cold arm on same size as the injection.

2021-03-07

Systemic reaction (other): Slight dizziness this morning, just feel kind of jittery and dazed

2021-03-08

Systemic reaction (other): Swollen lymph nodes in neck and feeling short of jittery

2021-03-09

Systemic reaction (other): Bruise at injection site

Release 5 — day 7, dose 2

2021-03-11

Systemic reaction (other): Arm & hand feel cold on right side, same side as injection

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Shaky and fast heart beat. Also right hand gets cold, same side as injection.

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	Heart rate increased	✓	✓	✓
SD	Peripheral coldness	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling jittery	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Tremor	✓	✓	✓

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