6NM-21668-00552

5 vaccinations 15 coded responses 59 check-ins 16 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 207 / MD
Registered: 2021-03-02

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

2021-02-19
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia oral, Lip swelling, Medical observation — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Numbness and swelling of lips · Healthcare visit (other): The pharmacist who vaccinated me gave me Benadryl and observed me on and off for an hour since I had some numbness and swelling of my lips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 0, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Heart rate increased — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: High resting pulse (100) and labored breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: No fever today, but fever late last night up to 101.6

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to work

Free text: Rash below injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2021-11-19
Survey response — day 0, dose 3
MedDRA: Hypersensitivity, Hypoaesthesia oral, Hypopnoea, Immediate post-injection reaction, Lip swelling, Medical observation — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Allergic reaction with swelling and numbness of lips, Some shallow breathing · Healthcare visit (other): Given Benadryl at vaccination site and observed for 45 minutes until symptoms lessened

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 0, 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

1 call case(s)
2021-11-20
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate increased, Hypopnoea — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shallow breathing, elevated heart rate (95-103 resting)

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate increased, Hypopnoea — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Joint pains, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shallow breathing, elevated heartbeat

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Hypopnoea — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shallow breathing, coughing

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Some shallow breathing

Adult check-in · check-in free text available
2021-11-23
Call 1 — Left Voicemail
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Hypopnoea — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shallow breathing, coughing

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain, Cough — Feeling: Fair · Fatigue or tiredness

Free text: Chest soreness, coughing

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — day 7, dose 3
MedDRA: Chest pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Chest soreness

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-27
Dose 4 — Pfizer-BioNTech
2022-05-28
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Swollen glands

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-31
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains · Be unable to work or attend school

Adult check-in
2022-06-02
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to work or attend school

Free text: Some occasional neck gland swelling for the past three

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Health check-in — day 7, dose 4
Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2022-06-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-24
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-26
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-25
Survey response — 6 months, dose 4
MedDRA: Ear infection — 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

Free text: Ear infection in September

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Report sent to call center — 6 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 · 1 call case(s)
2022-11-28
Call 2 — Left Voicemail
2022-11-28
Call 1 — Left Voicemail
2022-12-22
Dose 5 — Pfizer-BioNTech
2022-12-23
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-12-24
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-12-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-12-26
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling · Joint pains

Adult check-in
2022-12-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains

Adult check-in
2022-12-28
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains

Adult check-in
2022-12-29
Health check-in — day 7, dose 5
Feeling: Fair · Joint pains

Adult check-in
2023-01-05
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-01-12
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-01-19
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2023-01-26
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2023-02-02
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-03-23
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-06-23
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-11-19	Moderna	No
4	2022-05-27	Pfizer-BioNTech	No
5	2022-12-22	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 6 — day 0, dose 2

2021-03-19

Systemic reaction (other): Numbness and swelling of lips

Healthcare visit (other): The pharmacist who vaccinated me gave me Benadryl and observed me on and off for an hour since I had some numbness and swelling of my lips

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): High resting pulse (100) and labored breathing

2021-03-21

Systemic reaction (other): No fever today, but fever late last night up to 101.6

2021-03-22

Systemic reaction (other): Rash below injection site

Release 10 — day 0, dose 3

2021-11-19

Systemic reaction (other): Allergic reaction with swelling and numbness of lips, Some shallow breathing

Healthcare visit (other): Given Benadryl at vaccination site and observed for 45 minutes until symptoms lessened

Release 10 — days 1–6 daily, dose 3

2021-11-20

Systemic reaction (other): Shallow breathing, elevated heart rate (95-103 resting)

2021-11-21

Systemic reaction (other): Shallow breathing, elevated heartbeat

2021-11-22

Systemic reaction (other): Shallow breathing, coughing

2021-11-24

Systemic reaction (other): Shallow breathing, coughing

2021-11-25

Systemic reaction (other): Chest soreness, coughing

Release 10 — day 7, dose 3

2021-11-26

Systemic reaction (other): Chest soreness

Release 11 — days 1–6 daily, dose 4

2022-05-28

Systemic reaction (other): Swollen glands

2022-05-31

Systemic reaction (other): Shortness of breath

2022-06-02

Systemic reaction (other): Some occasional neck gland swelling for the past three

Release 12 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): Some shallow breathing

Release 12 — 6 months, dose 4

2022-11-25

Symptoms: Ear infection in September

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	Hypoaesthesia oral	✓	✓	✓
HCVO	Immediate post-injection reaction	·	·	✓
HCVO	Lip swelling	✓	✓	✓
HCVO	Medical observation	✓	✓	✓
SD	Ear infection	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Cough	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hypersensitivity	·	·	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Hypopnoea	·	·	✓
SRO	Injection site rash	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Pyrexia	✓	✓	✓

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