5D9-86470-48692

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 956 / CA
Registered: 2021-01-22

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

2021-01-21
Dose 1 — Moderna
2021-01-22
Registered in v-safe
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — day 14, dose 1
MedDRA: Feeling abnormal, Feeling hot, Flushing, Headache, Injection site erythema, Injection site mass, Injection site rash, Injection site warmth, Poor quality sleep, Rash erythematous — Feeling: Fair · Be unable to do your normal daily activities

Free text: 10 days in, developed large lump and huge, warm red rash at injection site. My face would get hot and flushed, but no fever. Brain fog, restless sleep and headaches. 5 days after side effects appeard, most symtoms have passed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Headache

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Survey response — day 21, dose 2
MedDRA: Urticaria, Vasculitis — Feeling: Poor · 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: Hives/vascultis on lower limbs, on set 5/5/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — day 28, dose 2
MedDRA: Headache, Pre-existing disease, Sinus congestion — Feeling: Poor · 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: Reoccuring vasculitis of lower limbs. Sinus congestion and headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — day 35, dose 2
MedDRA: Sinusitis, Vasculitis — Feeling: Poor · Be unable to work, 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: reoccuring vasculitis, sinus infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Sinusitis — Feeling: Fair · Be unable to work, 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: Coninued inlammatory conditions. Reoccuring leukocytoclastic vasculitis of the lower limbs and sinusitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-23
Survey response — 12 months, dose 2
MedDRA: IgA nephropathy — Feeling: Good · 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: Diagnosed with IGA Nephropothy which is believed to be triggered by the vaccine. I was not symptomatic prior to receiving the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-02-23
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-24
Call 1 — Left Voicemail
2022-02-24
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-23	Moderna

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 3 — day 14, dose 1

2021-02-04

Symptoms: 10 days in, developed large lump and huge, warm red rash at injection site. My face would get hot and flushed, but no fever. Brain fog, restless sleep and headaches. 5 days after side effects appeard, most symtoms have passed.

Release 5 — day 21, dose 2

2021-03-16

Symptoms: Hives/vascultis on lower limbs, on set 5/5/21.

Release 6 — day 28, dose 2

2021-03-23

Symptoms: Reoccuring vasculitis of lower limbs. Sinus congestion and headaches.

Release 6 — day 35, dose 2

2021-03-30

Symptoms: reoccuring vasculitis, sinus infection

Release 7 — day 42, dose 2

2021-04-06

Symptoms: Coninued inlammatory conditions. Reoccuring leukocytoclastic vasculitis of the lower limbs and sinusitis

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Diagnosed with IGA Nephropothy which is believed to be triggered by the vaccine. I was not symptomatic prior to receiving the vaccine.

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	Condition aggravated	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Flushing	✓	✓	✓
SD	Headache	✓	✓	✓
SD	IgA nephropathy	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site mass	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Poor quality sleep	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vasculitis	✓	✓	✓

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