6DJ-21958-21358

1 vaccination 9 coded responses 12 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 152 / PA
Registered: 2021-02-20

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

2021-02-17
Dose 1 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — day 14, dose 1
MedDRA: Nodule — Feeling: Good

Free text: Very large lumps appeared last week under injection arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 21, dose 1
MedDRA: Axillary mass, Medical counselling, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Large vaccination-side (L) underarm lump - solid mass. Larger than I expected from reading about this side effect. About 4in L x 2in W. No soreness. Slight itchy area on left lower arm and inner leg near knee. · Healthcare visit (other): Phone consult with PCP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Survey response — day 28, dose 1
MedDRA: Axillary mass, Blood test, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: The lumps under my L arm post #1 vax continue to be very concerning. Saw my Doctor on Mon. Had blood tests today. An imaging test is scheduled for Monday. · Healthcare visit (other): In person office visit and central testing lab in hospital for blood tests.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 35, dose 1
MedDRA: Axillary mass, Fatigue, Oedema peripheral, Unevaluable event — Feeling: Fair · 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: Symptoms: Fatigue The lumps and swelling under the injection arm · Healthcare visit (other): Had U/S and mammogram

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 35, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — day 42, dose 1
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Daytime fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — 3 months, dose 1
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Daily fatigue. Continued debilitating Covid arm in L axilla. Adenopathy continues after Feb 17 1st dose. My safety for a second Moderna dose is in serious question.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-20
Survey response — 6 months, dose 1
MedDRA: Condition aggravated, Pre-existing disease — 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, Emergency room or emergency department visit

Free text: Relapse of NH Lymphoma

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-23
Call successful
Participant prefers to complete VAERS report online
2022-02-17
Survey response — 12 months, dose 1
MedDRA: Axillary mass, Condition aggravated, Lymphadenopathy, Pre-existing disease — 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, Emergency room or emergency department visit, Hospitalization

Free text: NHL relapse last year attributed to my vaccination in L arm last February. A significant adenopathy in this arm has been treated with Rituximab. While lumps have become smaller, radiation Tx has been prescribed based on PetCT results.

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Report sent to call center — 12 months, dose 1
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-18
Call 1 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna

Call center

5 call center cases

4 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): No

Release 5 — day 14, dose 1

2021-03-03

Symptoms: Very large lumps appeared last week under injection arm.

Release 5 — day 21, dose 1

2021-03-10

Symptoms: Large vaccination-side (L) underarm lump - solid mass. Larger than I expected from reading about this side effect. About 4in L x 2in W. No soreness. Slight itchy area on left lower arm and inner leg near knee.

Healthcare visit (other): Phone consult with PCP.

Release 5 — day 28, dose 1

2021-03-17

Symptoms: The lumps under my L arm post #1 vax continue to be very concerning. Saw my Doctor on Mon. Had blood tests today. An imaging test is scheduled for Monday.

Healthcare visit (other): In person office visit and central testing lab in hospital for blood tests.

Release 6 — day 35, dose 1

2021-03-24

Symptoms: Fatigue The lumps and swelling under the injection arm

Healthcare visit (other): Had U/S and mammogram

Release 6 — day 42, dose 1

2021-03-31

Symptoms: Daytime fatigue

Release 8 — 3 months, dose 1

2021-05-19

Symptoms: Daily fatigue. Continued debilitating Covid arm in L axilla. Adenopathy continues after Feb 17 1st dose. My safety for a second Moderna dose is in serious question.

Release 9 — 6 months, dose 1

2021-08-20

Symptoms: Relapse of NH Lymphoma

Release 11 — 12 months, dose 1

2022-02-17

Symptoms: NHL relapse last year attributed to my vaccination in L arm last February. A significant adenopathy in this arm has been treated with Rituximab. While lumps have become smaller, radiation Tx has been prescribed based on PetCT results.

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	Blood test	✓	✓	○
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Axillary mass	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Nodule	✓	✓	✓
SD	Oedema peripheral	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pruritus	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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