6UA-29084-67937

2 vaccinations 14 coded responses 16 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 300 / GA
Registered: 2021-03-24

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

2021-02-24
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Dose 2 — Moderna
2021-03-24
Survey response — day 0, dose 2
MedDRA: Pruritus, Vision blurred — Feeling: Fair · Site: Itching

Free text: Itching on face, blurred vision in right eye that lasted about an hour. Got shot in right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pain, Pruritus, Vomiting — Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain

Free text: Only threw up once, itching on entire body not just arm, aches started about 2 hours ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pruritus, Joint swelling — Feeling: Good

Free text: All over itching, not any more at injection sight, still slight swelling around ankles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Nausea

Free text: Itching all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Nausea

Free text: All over itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Still slight itching all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Good · Abdominal pain

Free text: Still itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 14, dose 2
MedDRA: Pruritus — Feeling: Fair

Free text: The itching is getting worse especially at night!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 28, dose 2
MedDRA: Pruritus — Feeling: Fair

Free text: The itching is constant! Especially upper body jaw neck chest arms!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 35, dose 2
MedDRA: Pruritus, Rash — Feeling: Fair

Free text: The itch is not only continuing but its spreading and now I have a rash on my chest and it comes and goes on my arms. Please tell me how long should I expect this to go on?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-23
Survey response — 3 months, dose 2
MedDRA: Basal cell carcinoma, Impaired healing, Office visit, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Continued itch, Basal cell carcinoma, slow healing, I never had skin issues until after the itch caused by vaccine · Healthcare visit (other): Dermatologist and then mohs surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-30
Call successful
Participant prefers to complete VAERS report online
2021-09-22
Survey response — 6 months, dose 2
MedDRA: COVID-19, Dyspnoea, Lung disorder, Pneumonia — Feeling: Poor · 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

Free text: Covid, pneumonia, severe inability to breathe, severe decreased lung capacity 8 weeks later. Vaccine didnt keep me safe from covid. I feel Ive been lied to about the vaccine and I no longer trust cdc. Dont send me any more questionnaires.

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
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

1 call case(s)
2021-09-24
Call successful
Participant prefers to complete VAERS report online
2022-03-24
Survey response — 12 months, dose 2
MedDRA: Chest discomfort, Chronic obstructive pulmonary disease, Dyspnoea, Lung opacity, Office visit — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tightness in my chest continues, I can't breathe well outside And in certain situations inside. My doctor has told me I have grounded glass opacities and COPD now.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-24	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 0, dose 2

2021-03-24

Systemic reaction (other): Itching on face, blurred vision in right eye that lasted about an hour. Got shot in right arm

Release 6 — days 1–6 daily, dose 2

2021-03-25

Systemic reaction (other): Only threw up once, itching on entire body not just arm, aches started about 2 hours ago

2021-03-26

Systemic reaction (other): All over itching, not any more at injection sight, still slight swelling around ankles

2021-03-27

Systemic reaction (other): Itching all over

2021-03-28

Systemic reaction (other): All over itching

2021-03-29

Systemic reaction (other): Itching

2021-03-30

Systemic reaction (other): Still slight itching all over

Release 6 — day 7, dose 2

2021-03-31

Systemic reaction (other): Still itching

Release 7 — day 14, dose 2

2021-04-07

Symptoms: The itching is getting worse especially at night!

Release 7 — day 28, dose 2

2021-04-21

Symptoms: The itching is constant! Especially upper body jaw neck chest arms!

Release 8 — day 35, dose 2

2021-04-28

Symptoms: The itch is not only continuing but its spreading and now I have a rash on my chest and it comes and goes on my arms. Please tell me how long should I expect this to go on?

Release 9 — 3 months, dose 2

2021-06-23

Symptoms: Continued itch, Basal cell carcinoma, slow healing, I never had skin issues until after the itch caused by vaccine

Healthcare visit (other): Dermatologist and then mohs surgery

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: Covid, pneumonia, severe inability to breathe, severe decreased lung capacity 8 weeks later. Vaccine didnt keep me safe from covid. I feel Ive been lied to about the vaccine and I no longer trust cdc. Dont send me any more questionnaires.

Release 11 — 12 months, dose 2

2022-03-24

Symptoms: Tightness in my chest continues, I can't breathe well outside And in certain situations inside. My doctor has told me I have grounded glass opacities and COPD now.

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	Basal cell carcinoma	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Chronic obstructive pulmonary disease	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Impaired healing	✓	✓	✓
SD	Lung disorder	·	·	✓
SD	Lung opacity	·	·	✓
SD	Office visit	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Vision blurred	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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