5TX-32841-92842

4 vaccinations 18 coded responses 34 check-ins 18 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 610 / IL
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good · Muscle or body aches

Free text: Burning at injection site for only a few minutes after shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Urticaria — Feeling: Good · Joint pains, Muscle or body aches

Free text: One hive

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Nodule — Feeling: Fair · Muscle or body aches

Free text: Noticed painful lump inside left elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Limb mass — Feeling: Good · Muscle or body aches

Free text: Still have lump inside of elbow on opposite arm of injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Induration, Lymphadenopathy — Feeling: Good · Muscle or body aches

Free text: Still have sore lump inside left elbow. Swollen gland?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass — Feeling: Good · Muscle or body aches

Free text: Small lump in left arm inside elbow. Swollen gland?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 7, dose 1
MedDRA: Musculoskeletal stiffness, Nodule — Feeling: Good · Muscle or body aches

Free text: Same lump in arm. Stiff neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 14, dose 1
MedDRA: Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Congestion and runny nose and sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Nausea

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches

Free text: Accelerated heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Limb mass — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever

Free text: Still have small lump inside elbow of opposite arm. (Reported during first shot.)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Muscle or body aches

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Muscle or body aches

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fever · None

Adult check-in
2021-03-12
Survey response — day 14, dose 2
MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good

Free text: My arm is discolored at the injection site. It almost looks blue or gray kind of like a bruise.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 35, dose 2
MedDRA: Back pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Back pain — Feeling: Good · 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: Lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Back disorder, Intervertebral disc disorder — Feeling: Good · 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: Disk-related back problems

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Call 1 — Left Voicemail
2021-09-30
Call 2 — Left Voicemail
2021-10-29
Dose 3 — Moderna
2022-02-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-28
Survey response — day 14, dose 4
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Skin rash

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-29
Call successful
Not applicable - Accidental Reporting
2022-04-29
Call successful
Not applicable - Accidental Reporting
2022-04-29
Call successful
Not applicable - Accidental Reporting
2022-05-08
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-13
Survey response — day 35, dose 4
MedDRA: Abdominal discomfort, Flushing, Pyrexia, SARS-CoV-2 test — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fever, flushing, stomach upset. · Healthcare visit (other): Went to get a Covid test

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Survey response — 3 months, dose 4
MedDRA: COVID-19 — 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, Outpatient clinic or urgent care clinic visit

Free text: I caught COVID

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — 3 months, dose 4
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-11
Call successful
Participant prefers to complete VAERS report online
2022-10-09
Survey response — 6 months, dose 4
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Rash on legs

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-10
Call successful
Not applicable - Accidental Reporting
2023-04-08
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-10-29	Moderna	No
4	2022-04-08	Moderna	No

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-01-29

Systemic reaction (other): Burning at injection site for only a few minutes after shot.

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): One hive

2021-01-31

Systemic reaction (other): Noticed painful lump inside left elbow

2021-02-01

Systemic reaction (other): Still have lump inside of elbow on opposite arm of injection site

2021-02-03

Systemic reaction (other): Still have sore lump inside left elbow. Swollen gland?

2021-02-04

Systemic reaction (other): Small lump in left arm inside elbow. Swollen gland?

Release 3 — day 7, dose 1

2021-02-05

Systemic reaction (other): Same lump in arm. Stiff neck.

Release 4 — day 14, dose 1

2021-02-12

Symptoms: Congestion and runny nose and sneezing

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Accelerated heart rate

2021-03-01

Systemic reaction (other): Still have small lump inside elbow of opposite arm. (Reported during first shot.)

Release 5 — day 14, dose 2

2021-03-12

Symptoms: My arm is discolored at the injection site. It almost looks blue or gray kind of like a bruise.

Release 6 — day 35, dose 2

2021-04-02

Symptoms: Lower back pain

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Lower back pain

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Disk-related back problems

Release 11 — day 14, dose 4

2022-04-28

Symptoms: Skin rash

Release 11 — day 35, dose 4

2022-05-13

Symptoms: Fever, flushing, stomach upset.

Healthcare visit (other): Went to get a Covid test

Release 12 — 3 months, dose 4

2022-07-08

Symptoms: I caught COVID

Release 12 — 6 months, dose 4

2022-10-09

Symptoms: Rash on legs

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	SARS-CoV-2 test	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Back disorder	✓	·	✓
SD	Back pain	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Flushing	·	·	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site discolouration	✓	✓	✓
SD	Intervertebral disc disorder	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary mass	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Induration	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Limb mass	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	○
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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