U36-24366-11216

3 vaccinations 15 coded responses 36 check-ins 15 free-text entries 7 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 620 / IL
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · None

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache · Be unable to do your normal daily activities

Adult check-in
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-06
Survey response — day 7, dose 1
MedDRA: Injection site urticaria, Office visit — Feeling: Fair · Site: Redness, Swelling, Itching · None · Get care from a doctor or other healthcare professional

Free text: OCCUPATIONAL HEALTH JUST TO SHOW THEM THE HIVE AT THE INJECTION SITE NO TREATMWNT GIVEN

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-13
Survey response — day 14, dose 1
MedDRA: Injection site urticaria, Migraine — Feeling: Fair · Be unable to do your normal daily activities

Free text: Large hive about the size of a softball hit on injection site for 3 days finanally dying down this week. Also migraine started again and has lasted for 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-20
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: 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: Elevated heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Redness, Swelling, Itching · Headache

Free text: Sudden swollen lymph node under my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 28, dose 2
MedDRA: Migraine — Feeling: Fair · Be unable to do your normal daily activities

Free text: Migraine that will not go away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-28
Survey response — 3 months, dose 2
MedDRA: Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work, 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: Fever of 103+ for 5 days. Tested negative for Covid 2 times and tested negative for other Rrspiratoey diseases and negative for ear infection, strep throat and ear infection. No explaination or other symptoms besides extremely high fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — 3 months, 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)
2021-06-15
Call 1 — Left Voicemail
2021-07-28
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain, Breast swelling, Neck pain, Oedema peripheral, Swelling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Diarrhea · Be unable to work or attend school

Free text: Moderate swelling and pain in armpit and breast spreading upward intobneckbon side of injection site

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain, Headache, Neck pain, Oedema peripheral, Pain, Pain in extremity, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains · Be unable to do your normal daily activities

Free text: Pain and swelling under arm where injection was given pain and swelling extend down the arm and into that breast oain also shoots up into my neck and head

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Axillary pain, Breast pain, Breast swelling, Joint swelling, Neck pain, Oedema peripheral, Swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Pain and mild swelling under arm of injection extending to that breast and up into my neck and shoulder joint

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain, Breast swelling, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling, Itching · Headache · Be unable to do your normal daily activities

Free text: Still swollen under arm and over to breast. With mild to moderate pain there.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Contusion, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Headache · Be unable to do your normal daily activities

Free text: Brusing around the swelling under the arm of the injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — day 7, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Swelling under arm where injection was given

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — day 14, dose 3
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme headache

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Survey response — day 42, dose 3
MedDRA: Neuralgia, Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nerve pain and issues in right arm · Healthcare visit (other): Appointment with orthopedic doctor

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-13
Call successful
Does not wish to fill out VAERS report
2021-12-13
Call successful
Does not wish to fill out VAERS report
2021-12-13
Call successful
Does not wish to fill out VAERS report
2021-12-13
Call successful
Does not wish to fill out VAERS report
2021-12-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-12-31
Call successful
Does not wish to fill out VAERS report
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Asthma, Blood pressure inadequately controlled, COVID-19, Hypertension — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Caught covid and now have really high uncontrolled BP and asthma

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
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	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-10-28	Moderna	No

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 1 — day 7, dose 1

2021-01-06

Healthcare visit (other): OCCUPATIONAL HEALTH JUST TO SHOW THEM THE HIVE AT THE INJECTION SITE NO TREATMWNT GIVEN

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Large hive about the size of a softball hit on injection site for 3 days finanally dying down this week. Also migraine started again and has lasted for 3 days.

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Elevated heart rate

2021-01-31

Systemic reaction (other): Sudden swollen lymph node under my arm

Release 4 — day 28, dose 2

2021-02-24

Symptoms: Migraine that will not go away

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Fever of 103+ for 5 days. Tested negative for Covid 2 times and tested negative for other Rrspiratoey diseases and negative for ear infection, strep throat and ear infection. No explaination or other symptoms besides extremely high fever.

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Moderate swelling and pain in armpit and breast spreading upward intobneckbon side of injection site

2021-10-31

Systemic reaction (other): Pain and swelling under arm where injection was given pain and swelling extend down the arm and into that breast oain also shoots up into my neck and head

2021-11-01

Systemic reaction (other): Pain and mild swelling under arm of injection extending to that breast and up into my neck and shoulder joint

2021-11-02

Systemic reaction (other): Still swollen under arm and over to breast. With mild to moderate pain there.

2021-11-03

Systemic reaction (other): Brusing around the swelling under the arm of the injection

Release 10 — day 7, dose 3

2021-11-06

Systemic reaction (other): Swelling under arm where injection was given

Release 10 — day 14, dose 3

2021-11-14

Symptoms: Extreme headache

Release 10 — day 42, dose 3

2021-12-11

Symptoms: Nerve pain and issues in right arm

Healthcare visit (other): Appointment with orthopedic doctor

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Caught covid and now have really high uncontrolled BP and asthma

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	Injection site urticaria	✓	✓	✓
HCVO	Medical observation	○	○	○
HCVO	Office visit	✓	✓	✓
SD	Asthma	·	·	✓
SD	Blood pressure inadequately controlled	·	·	✓
SD	COVID-19	·	·	✓
SD	Headache	·	·	✓
SD	Hypertension	·	·	✓
SD	Injection site urticaria	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Neuralgia	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Breast pain	·	·	✓
SRO	Breast swelling	·	·	✓
SRO	Contusion	·	·	✓
SRO	Headache	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Joint swelling	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Swelling	·	·	✓

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