632-15795-95343

3 vaccinations 6 coded responses 19 check-ins 6 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 379 / TN
Registered: 2021-03-31

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

2021-02-26
Dose 1 — Moderna
2021-03-26
Dose 2 — Moderna
2021-03-31
Registered in v-safe
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site nodule, Injection site swelling, Injection site warmth, Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): I have a very hard knot about 3 1/2 to 4 inches under the red hot swollen spot on my arm at the injection site · Healthcare visit (other): I am allergic to many medications so when it got larger each day for four days after injection I called the PCP and they asked me to come in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site swelling, Injection site warmth — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Injection site is very very warm and has gotten much larger today. It has progressively grown over the past six days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-09
Survey response — day 14, dose 2
MedDRA: Peripheral swelling, Skin discolouration, Urinary tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have developed a very bad UTI.My Covid arm is still discolored and still a little swollen. It itches more now than before. It is not as hot as it was before.

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

1 call case(s)
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Erythema, Hospitalisation, Peripheral swelling, Pruritus, Transient ischaemic attack — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I have had two TIA,s and was hospitalized for them both. The reaction I had to the covid shot where my arm was read and swollen and itched all the way around my left arm was the arm that both TIAs affected. Coincident.? Not sure if its relate

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-09-27
Call successful
Participant prefers to complete VAERS report online
2021-10-22
Dose 3 — Moderna
Co-administered: Flu
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · Diarrhea

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Emergency care, Influenza virus test negative, Nausea, SARS-CoV-2 test negative, Unevaluable event, Vomiting — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Vomited once and had the worst diarrhea I have ever had got 6 straight days. Nausea temp and diarrhea. Wound up at (b)(6) emergency room. They gave me fluids and meds for nausea and diarrhea did a Covid test and flu test both of which were negative.

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-01-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-22
Survey response — 6 months, dose 3
MedDRA: COVID-19, Office visit — 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: Symptoms: I had covid in February. · Healthcare visit (other): Two visits to my regular primary care doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 6 months, 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)
2022-04-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-10-22	Moderna	Flu

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): I have a very hard knot about 3 1/2 to 4 inches under the red hot swollen spot on my arm at the injection site

Healthcare visit (other): I am allergic to many medications so when it got larger each day for four days after injection I called the PCP and they asked me to come in.

2021-04-01

Systemic reaction (other): Injection site is very very warm and has gotten much larger today. It has progressively grown over the past six days.

Release 7 — day 14, dose 2

2021-04-09

Symptoms: I have developed a very bad UTI.My Covid arm is still discolored and still a little swollen. It itches more now than before. It is not as hot as it was before.

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: I have had two TIA,s and was hospitalized for them both. The reaction I had to the covid shot where my arm was read and swollen and itched all the way around my left arm was the arm that both TIAs affected. Coincident.? Not sure if its relate

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Vomited once and had the worst diarrhea I have ever had got 6 straight days. Nausea temp and diarrhea. Wound up at (b)(6) emergency room. They gave me fluids and meds for nausea and diarrhea did a Covid test and flu test both of which were negative. cut off by CDC

redacted (b)(6)

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: I had covid in February.

Healthcare visit (other): Two visits to my regular primary care doctor.

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	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Erythema	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Nausea	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Skin discolouration	✓	✓	✓
SD	Transient ischaemic attack	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓

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