7KK-19111-40543

3 vaccinations 11 coded responses 27 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 405 / KY
Registered: 2021-05-29

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

2021-05-29
Registered in v-safe
2021-05-29
Dose 1 — Moderna
2021-05-29
Survey response — day 0, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bruising distal to the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Bruising distal to injection site. It is the length and width of a business card.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good

Free text: The bruise distal to the injection site is starting to clear a little.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — days 1–6 daily, dose 1
MedDRA: Contusion — Feeling: Good · Joint pains · Be unable to do your normal daily activities

Free text: Bruise that is distal to the vaccine injection site is the same as 310521

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Fair · Joint pains

Free text: Bruise distal to the injection site on the tricep still present.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good

Free text: The bruise distal to the injection site has started to resolve a little.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Survey response — day 7, dose 1
MedDRA: Injection site bruising — Feeling: Good · Joint pains

Free text: The bruise distal to the injection site has resolved to half the size of a business card and appears to be clearing up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-06-26
Dose 2 — Moderna
2021-06-28
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Bruise distal to the injection site. It is about the size of a nickle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good

Free text: The bruise distal to the injection site has cleared.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-07-03
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-07-12
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-07-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-31
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-12-27
Survey response — 6 months, dose 2
MedDRA: Conjunctivitis, Medical procedure, Meibomian gland dysfunction, Migraine, Raynaud's phenomenon, Sacroiliac joint dysfunction, Spinal osteoarthritis, Upper respiratory tract 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Raynaud's, Meibomian Gland Dysfunction, Migraines, SIJ Dysfunction, Lumbar Spondylosis, Upper Respiratory Infection with Conjunctivitis · Healthcare visit (other): Outpatient procedures

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-28
Call 1 — Left Voicemail
2022-02-25
Dose 3 — Moderna
2022-02-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-03-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-03-04
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-03-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-03-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-03-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-04-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-04-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-05-29
Survey response — 3 months, dose 3
MedDRA: Gastrointestinal disorder, Office visit — 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

Free text: Symptoms: Gastrointestinal, possible rectocele( sp) or blockage. Still in diagnostic testing. · Healthcare visit (other): Gastrointestinal Specialist

MedDRA releases: 2024-11 · check-in free text available
2022-05-29
Report sent to call center — 3 months, dose 3
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)
2022-06-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-29	Moderna
2	2021-06-26	Moderna	No
3	2022-02-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-27	Successful 2022-06-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-29	Successful 2022-06-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 8 — day 0, dose 1

2021-05-29

Systemic reaction (other): Bruising distal to the injection site

Release 8 — days 1–6 daily, dose 1

2021-05-30

Systemic reaction (other): Bruising distal to injection site. It is the length and width of a business card.

2021-05-31

Systemic reaction (other): The bruise distal to the injection site is starting to clear a little.

2021-06-01

Systemic reaction (other): Bruise that is distal to the vaccine injection site is the same as 310521

2021-06-02

Systemic reaction (other): Bruise distal to the injection site on the tricep still present.

2021-06-04

Systemic reaction (other): The bruise distal to the injection site has started to resolve a little.

Release 8 — day 7, dose 1

2021-06-07

Systemic reaction (other): The bruise distal to the injection site has resolved to half the size of a business card and appears to be clearing up.

Release 9 — days 1–6 daily, dose 2

2021-06-28

Systemic reaction (other): Bruise distal to the injection site. It is about the size of a nickle.

2021-07-01

Systemic reaction (other): The bruise distal to the injection site has cleared.

Release 10 — 6 months, dose 2

2021-12-27

Symptoms: Raynaud's, Meibomian Gland Dysfunction, Migraines, SIJ Dysfunction, Lumbar Spondylosis, Upper Respiratory Infection with Conjunctivitis

Healthcare visit (other): Outpatient procedures

Release 11 — 3 months, dose 3

2022-05-29

Symptoms: Gastrointestinal, possible rectocele( sp) or blockage. Still in diagnostic testing.

Healthcare visit (other): Gastrointestinal Specialist

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	Medical procedure	·	·	✓
HCVO	Office visit	·	·	✓
SD	Conjunctivitis	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Meibomian gland dysfunction	·	·	✓
SD	Migraine	·	·	✓
SD	Raynaud's phenomenon	·	·	✓
SD	Sacroiliac joint dysfunction	·	·	✓
SD	Spinal osteoarthritis	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓

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