5EY-31177-58800

3 vaccinations 11 coded responses 41 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 453 / OH
Registered: 2020-12-30

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

M7R-80401-72741 Child or adolescent in my care · Male · 2021-10-28

MD9-19718-41649 Child or adolescent in my care · Female · 2021-10-28

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Survey response — day 0, dose 1
MedDRA: Antinuclear antibody positive — Feeling: Good · Headache, Joint pains, Muscle or body aches

Free text: ANA positive

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Diarrhea

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · None · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Hospitalization

Adult check-in
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Good · Site: Pain, Swelling

Free text: Insomnia since injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Good

Free text: Insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: Good

Free text: At injection site swelling comes and goes. Some days you can see the welt and it's red warm and itchy. Then 2 days later it's just a red mark or no mark at all. I thought it was gone and today it popped up again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Call 1 — Left Voicemail
2021-01-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-30
Dose 2 — Moderna
2021-01-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-02-06
Survey response — day 7, dose 2
MedDRA: Contusion, Rash, Skin discolouration — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: I checked rash but It looks like I have a brownish/reddish bruise. Puts me in the mind of old blood behind the skin I have seen in some elderly patients that come in to the medical clinic I work at.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — day 14, dose 2
MedDRA: Injection site discolouration, Injection site pain, Injection site swelling — Feeling: Good

Free text: The area of injection is discolored. No more swelling or pain, just looks bad. If its not gone at my next month PCP appt I will have him take a look.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-27
Dose 3 — Moderna
Co-administered: Flu
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Armpit pain- lymph node swelling started closer to 48 hours after

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — day 7, dose 3
MedDRA: Lymph node pain — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: Lymph node under arm is still alil tender but improving

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Survey response — day 14, dose 3
MedDRA: Headache, Nausea — 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 · Outpatient clinic or urgent care clinic visit

Free text: I have been nauseous & have a headache off an md on since I had my 3rd vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Report sent to call center — day 14, 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)
2021-11-12
Call 1 — Left Voicemail
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Survey response — day 35, dose 3
MedDRA: Headache, Influenza virus test negative, Nausea, SARS-CoV-2 test negative — Feeling: Fair · 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: Nauseous & Headache-Abbott ID Rapid Covid & Flu negative

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-02
Call successful
Participant prefers to complete VAERS report online
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Blood test abnormal, Hepatic enzyme increased, Office visit, Ultrasound liver abnormal — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I have had elevated liver enzyme's on my route bi annual blood work & now I have had a repeat test & "possibly cirrhosis of the liver" from a ultrasound, my PCP ordered. I now am going for a upper GI. No prior issues or factors,causing any cirrhosis · Healthcare visit (other): PCP & Gastric

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-27
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-27
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-30	Moderna
3	2021-10-27	Moderna	Flu

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-30

Systemic reaction (other): ANA positive

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Insomnia since injection

2021-01-03

Systemic reaction (other): Insomnia

Release 1 — day 14, dose 1

2021-01-13

Symptoms: At injection site swelling comes and goes. Some days you can see the welt and it's red warm and itchy. Then 2 days later it's just a red mark or no mark at all. I thought it was gone and today it popped up again

Release 3 — day 7, dose 2

2021-02-06

Systemic reaction (other): I checked rash but It looks like I have a brownish/reddish bruise. Puts me in the mind of old blood behind the skin I have seen in some elderly patients that come in to the medical clinic I work at.

Release 4 — day 14, dose 2

2021-02-13

Symptoms: The area of injection is discolored. No more swelling or pain, just looks bad. If its not gone at my next month PCP appt I will have him take a look.

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): Armpit pain- lymph node swelling started closer to 48 hours after

Release 10 — day 7, dose 3

2021-11-03

Systemic reaction (other): Lymph node under arm is still alil tender but improving

Release 10 — day 14, dose 3

2021-11-10

Symptoms: I have been nauseous & have a headache off an md on since I had my 3rd vaccine

Release 10 — day 35, dose 3

2021-12-01

Symptoms: Nauseous & Headache-Abbott ID Rapid Covid & Flu negative

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: I have had elevated liver enzyme's on my route bi annual blood work & now I have had a repeat test & "possibly cirrhosis of the liver" from a ultrasound, my PCP ordered. I now am going for a upper GI. No prior issues or factors,causing any cirrhosis cut off by CDC

Healthcare visit (other): PCP & Gastric

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	Office visit	·	·	✓
SD	Blood test abnormal	·	·	✓
SD	Headache	·	·	✓
SD	Hepatic enzyme increased	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Injection site discolouration	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Nausea	·	·	✓
SD	Office visit	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Ultrasound liver abnormal	·	·	✓
SRO	Antinuclear antibody positive	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Rash	✓	✓	✓
SRO	Skin discolouration	✓	✓	✓

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