66C-32284-60723

5 vaccinations 16 coded responses 46 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 206 / MD
Registered: 2021-10-06

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-10-06
Registered in v-safe
2021-10-06
Dose 1 — Moderna
2021-10-06
Survey response — day 0, dose 1
MedDRA: Lip swelling, Pruritus — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: 1. Itchy legs 2. Slight swelling of lips

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-10-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-11-03
Dose 2 — Moderna
2021-11-03
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Injection site pain, Pain, Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Within 15 minutes of receiving the 2nd dose, I had tingling in my fingers, primarily the pinky of the injection arm [left]. When the tingling subsided, there was a radiating pain in upper arm [approximately 2" below the injection site].

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Dehydration, Hyperhidrosis, Nausea, Pruritus, Respiratory tract congestion, Self-medication, Throat irritation — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Felt damp, but temperature was below 100Â°. Then my forearms (both) and abdomen was itchy. I took 2 Tylenol PM and slept through the night. I woke dehydrated & drank lots of water. I felt a little nauseous. My throat was itchy & NT congested.

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: I still have mild congestion in my nose and throat.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lip disorder, Oral herpes, Reaction to previous exposure to any vaccine — Feeling: Good · Fatigue or tiredness

Free text: Other than little cold sore/irritations on my upper and lower lip; I feel exceptionally well...much better than this period of time with the 1st shot! Not sure whether the progress is due to getting the 2nd shot in my less dominate arm or my immunity

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Nose & throat congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — day 7, dose 2
MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Still experiencing head, nose & throat congestion.

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

Adult check-in
2021-11-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-16
Survey response — day 42, dose 2
MedDRA: Headache, Nasopharyngitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe headache & cold symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-04-23
Dose 3 — Moderna
2022-04-23
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-24
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: I took 2 Bayer Back & Body for pain relief . Abdominal pain was very bad in the morning but subsided later.

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-28
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Feeling cold, Middle insomnia, Myalgia, Night sweats, Pyrexia, Throat irritation — Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: I woke up during the night feeling feverish and damp. I had chills & couldn't get warm. I had a scratchy throat also. The muscle aches were isolated primarily to my upper thighs.

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-27
Dose 4 — Moderna
2022-08-27
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-08-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-01
Survey response — days 1–6 daily, dose 4
MedDRA: Pruritus — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: Itchy: legs, arms, torso [front & back] & face

MedDRA releases: 2024-11 · check-in free text available
2022-09-02
Survey response — days 1–6 daily, dose 4
MedDRA: Pruritus — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: Itchy: arms, legs & torso [more back than front]

MedDRA releases: 2024-11 · check-in free text available
2022-09-05
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-11
Survey response — day 14, dose 4
MedDRA: Cough, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Pain — Feeling: Poor

Free text: I have a cold...no fever, but sore throat, body aches, dry cough & nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-09-26
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-03
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-10-08
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-11-27
Survey response — 3 months, dose 4
MedDRA: Cough, Fatigue, Nasal congestion, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nasal & sinus congestion with cough & fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Dose 5 — Moderna
2023-03-02
Survey response — 6 months, dose 4
MedDRA: COVID-19, Nasopharyngitis, Sinusitis — 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

MedDRA releases: 2024-11
2023-03-02
Report sent to call center — 6 months, dose 4
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)
2023-03-03
Call 1 — Requested Callback
2023-03-03
Callback requested for
05:00PM ET
2023-03-03
Call successful
Does not wish to fill out VAERS report
2023-03-22
Survey response — 3 months, dose 5
MedDRA: Increased upper airway secretion, Nasopharyngitis, Rhinorrhoea, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-06-21
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-06	Moderna	No
2	2021-11-03	Moderna	No
3	2022-04-23	Moderna	No
4	2022-08-27	Moderna	No
5	2022-12-20	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — day 0, dose 1

2021-10-06

Systemic reaction (other): 1. Itchy legs 2. Slight swelling of lips

Release 10 — day 0, dose 2

2021-11-03

Systemic reaction (other): Within 15 minutes of receiving the 2nd dose, I had tingling in my fingers, primarily the pinky of the injection arm [left]. When the tingling subsided, there was a radiating pain in upper arm [approximately 2" below the injection site].

Release 10 — days 1–6 daily, dose 2

2021-11-04

Systemic reaction (other): Felt damp, but temperature was below 100Â°. Then my forearms (both) and abdomen was itchy. I took 2 Tylenol PM and slept through the night. I woke dehydrated & drank lots of water. I felt a little nauseous. My throat was itchy & NT congested.

2021-11-05

Systemic reaction (other): I still have mild congestion in my nose and throat.

2021-11-07

Systemic reaction (other): Other than little cold sore/irritations on my upper and lower lip; I feel exceptionally well...much better than this period of time with the 1st shot! Not sure whether the progress is due to getting the 2nd shot in my less dominate arm or my immunity cut off by CDC

2021-11-09

Systemic reaction (other): Nose & throat congestion

Release 10 — day 7, dose 2

2021-11-11

Systemic reaction (other): Still experiencing head, nose & throat congestion.

Release 10 — day 42, dose 2

2021-12-16

Symptoms: Severe headache & cold symptoms

Release 11 — days 1–6 daily, dose 3

2022-04-24

Systemic reaction (other): I took 2 Bayer Back & Body for pain relief . Abdominal pain was very bad in the morning but subsided later.

2022-04-28

Systemic reaction (other): I woke up during the night feeling feverish and damp. I had chills & couldn't get warm. I had a scratchy throat also. The muscle aches were isolated primarily to my upper thighs.

Release 12 — days 1–6 daily, dose 4

2022-09-01

Systemic reaction (other): Itchy: legs, arms, torso [front & back] & face

2022-09-02

Systemic reaction (other): Itchy: arms, legs & torso [more back than front]

Release 12 — day 14, dose 4

2022-09-11

Symptoms: I have a cold...no fever, but sore throat, body aches, dry cough & nasal congestion

Release 12 — 3 months, dose 4

2022-11-27

Symptoms: Nasal & sinus congestion with cough & fatigue.

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Increased upper airway secretion	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Self-medication	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Chills	·	·	✓
SRO	Dehydration	·	·	✓
SRO	Feeling cold	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Lip disorder	·	·	✓
SRO	Lip swelling	·	·	✓
SRO	Middle insomnia	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Nausea	·	·	✓
SRO	Night sweats	·	·	✓
SRO	Oral herpes	·	·	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Throat irritation	·	·	✓

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