6QC-99587-16038

3 vaccinations 16 coded responses 39 check-ins 16 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 622 / IL
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes, Oral pain — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Cold sores and pain in my mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes, Oral pain, Pain in jaw — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Mouth/jaw pain..cold sores.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Oral pain, Pain in jaw — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Mouth pain/jaw pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes, Oral pain, Pain in jaw — Feeling: Good

Free text: Mouth/jaw pain getting better. Fever blisters getting better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Eye irritation, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat and burning eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 21, dose 1
MedDRA: Cough, Feeling cold, Nasal congestion — Feeling: Good · Be unable to work

Free text: Nasal congestion and cough. I felt like I had a cold. I had to get a Covid test to return to work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Dose 2 — Moderna
2021-02-19
Survey response — day 0, dose 2
MedDRA: Burning sensation, Nervousness, Tremor — Feeling: Fair · Site: Pain

Free text: I just received the vaccine an hour ago. I feel a bit shaky and my arm burns.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Breast pain, Pain in extremity — Feeling: Poor · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Under arm and side of breast pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Under arm pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Oedema peripheral — Feeling: Good · Site: Swelling · Joint pains

Free text: Swelling under arm. Joint hurts in the same arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 7, dose 2
MedDRA: Axillary pain, Breast pain, Breast swelling, Oedema peripheral — Feeling: Fair · Site: Swelling

Free text: Pain swelling arm pit and breast

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 42, dose 2
MedDRA: Pain in jaw — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Infected tooth that needs extraction. After my first vaccination I had jaw pain that caused me to clench and grind my teeth on that side. It cracked the root. I also developed cold sores on that side. No history of previous dental problems.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Axillary pain — Feeling: Good

Free text: My under arm area still hurts on and off. Sometimes wearing a bra hurts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Call 1 — Left Voicemail
2021-08-22
Survey response — 6 months, dose 2
MedDRA: Migraine, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Atypical migraines · Healthcare visit (other): Office visit. MRI scheduled

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-22
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)
2021-08-24
Call successful
Participant prefers to complete VAERS report online
2021-08-24
Call successful
Participant prefers to complete VAERS report online
2021-12-27
Dose 3 — Moderna
2021-12-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-12-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-07
Survey response — day 42, dose 3
MedDRA: Drug hypersensitivity, Oedema peripheral, Office visit, Surgery, Vein disorder — 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

Free text: Symptoms: I developed an allergy to PCN. My rt. arm pit has stayed swollen after the second COVID vaccine (Feb. 2021). After I had surgery last week, I had worse swelling and trouble with the IV/vein in my rt. arm pit. I never had trouble with IVs before. · Healthcare visit (other): Doctor's office

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Report sent to call center — day 42, 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)
2022-02-09
Call 1 — Could Not Reach Participant
2022-02-14
Call 2 — Could Not Reach Participant
2022-03-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-27
Survey response — 12 months, dose 3
MedDRA: Vitreous detachment — 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 · Outpatient clinic or urgent care clinic visit

Free text: Vitreous detachments in both eyes.

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Report sent to call center — 12 months, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-28
Call 1 — Left Voicemail
2022-12-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-12-27	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Cold sores and pain in my mouth.

2021-01-25

Systemic reaction (other): Mouth/jaw pain..cold sores.

2021-01-26

Systemic reaction (other): Mouth pain/jaw pain

2021-01-27

Systemic reaction (other): Mouth/jaw pain getting better. Fever blisters getting better

Release 3 — day 14, dose 1

2021-02-05

Symptoms: Sore throat and burning eyes

Release 4 — day 21, dose 1

2021-02-12

Symptoms: Nasal congestion and cough. I felt like I had a cold. I had to get a Covid test to return to work.

Release 4 — day 0, dose 2

2021-02-19

Systemic reaction (other): I just received the vaccine an hour ago. I feel a bit shaky and my arm burns.

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Under arm and side of breast pain

2021-02-24

Systemic reaction (other): Under arm pain

2021-02-25

Systemic reaction (other): Swelling under arm. Joint hurts in the same arm

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Pain swelling arm pit and breast

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Infected tooth that needs extraction. After my first vaccination I had jaw pain that caused me to clench and grind my teeth on that side. It cracked the root. I also developed cold sores on that side. No history of previous dental problems.

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: My under arm area still hurts on and off. Sometimes wearing a bra hurts.

Release 9 — 6 months, dose 2

2021-08-22

Symptoms: Atypical migraines

Healthcare visit (other): Office visit. MRI scheduled

Release 11 — day 42, dose 3

2022-02-07

Symptoms: I developed an allergy to PCN. My rt. arm pit has stayed swollen after the second COVID vaccine (Feb. 2021). After I had surgery last week, I had worse swelling and trouble with the IV/vein in my rt. arm pit. I never had trouble with IVs before.

Healthcare visit (other): Doctor's office

Release 12 — 12 months, dose 3

2022-12-27

Symptoms: Vitreous detachments in both eyes.

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	✓	·	✓
SD	Axillary pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Drug hypersensitivity	·	·	✓
SD	Eye irritation	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Migraine	✓	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Oedema peripheral	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Surgery	·	·	✓
SD	Vein disorder	·	·	✓
SD	Vitreous detachment	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Breast swelling	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Nervousness	·	·	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Oral pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Tremor	✓	✓	○

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