Y34-28064-99559

3 vaccinations 12 coded responses 36 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 914 / CA
Registered: 2021-04-09

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Moderna
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Oedema peripheral — Feeling: Fair · Site: Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to work

Free text: Swelling under my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fever · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — day 7, dose 1
Feeling: Fair · Site: Swelling · Headache, Joint pains

Adult check-in
2021-04-24
Survey response — day 14, dose 1
MedDRA: Ocular hyperaemia, Swelling of eyelid — Feeling: Fair

Free text: I passed with my right eye swollen only the art above and red, spend two days so and then it became normal then swollen again and I do not know if that has a loophole related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Moderna
2021-05-07
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Abdominal pain · Be unable to work

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches

Adult check-in
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Ear congestion, Nasal congestion, Ocular hyperaemia, Oropharyngeal pain, Respiratory tract congestion, Sinusitis — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: My Throat, it hurts and I feel congestion between my nose, throat, eyes, and ear. I feeling like I have a sinus infection please let me know if this is normal you can send me a email (b)(6) thank you.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-05-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-08
Survey response — 3 months, dose 2
MedDRA: Inflammation, Mastitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have breast mastitis and I have more inflammation inside then I was before.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-05
Survey response — 6 months, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Always have a pain in my legs, and headaches very often

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Call 1 — Left Voicemail
2021-12-30
Dose 3 — Moderna
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains, Diarrhea

Adult check-in
2022-01-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2022-01-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache

Adult check-in
2022-01-06
Health check-in — day 7, dose 3
Feeling: Fair · Fever · Chills, Headache, Joint pains

Adult check-in
2022-01-13
Survey response — day 14, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Survey response — day 21, dose 3
MedDRA: Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feverish sometimes.

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Survey response — day 28, dose 3
MedDRA: Chills — Feeling: Fair

Free text: Chills

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Survey response — day 35, dose 3
MedDRA: Chills, Fatigue — Feeling: Fair

Free text: Chills and very tiredness.

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-31
Survey response — 3 months, dose 3
MedDRA: Chest discomfort — Feeling: Fair

Free text: Sometimes pressure in my chest.

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-01-01
Survey response — 12 months, dose 3
MedDRA: Fatigue — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-07	Moderna
3	2021-12-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-08	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-12

Systemic reaction (other): Swelling under my arm

Release 7 — day 14, dose 1

2021-04-24

Symptoms: I passed with my right eye swollen only the art above and red, spend two days so and then it became normal then swollen again and I do not know if that has a loophole related to the vaccine.

Release 8 — days 1–6 daily, dose 2

2021-05-13

Systemic reaction (other): My Throat, it hurts and I feel congestion between my nose, throat, eyes, and ear. I feeling like I have a sinus infection please let me know if this is normal you can send me a email (b)(6) thank you.

redacted (b)(6)

Release 9 — day 42, dose 2

2021-06-18

Symptoms: Headache

Release 9 — 3 months, dose 2

2021-08-08

Symptoms: I have breast mastitis and I have more inflammation inside then I was before.

Release 10 — 6 months, dose 2

2021-11-05

Symptoms: Always have a pain in my legs, and headaches very often

Release 10 — day 14, dose 3

2022-01-13

Symptoms: Sore throat

Release 11 — day 21, dose 3

2022-01-22

Symptoms: Feverish sometimes.

Release 11 — day 28, dose 3

2022-01-27

Symptoms: Chills

Release 11 — day 35, dose 3

2022-02-03

Symptoms: Chills and very tiredness.

Release 11 — 3 months, dose 3

2022-03-31

Symptoms: Sometimes pressure in my chest.

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
SD	Chest discomfort	·	·	✓
SD	Chills	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Inflammation	✓	·	✓
SD	Mastitis	✓	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pyrexia	·	·	✓
SD	Swelling of eyelid	✓	✓	✓
SRO	Ear congestion	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sinusitis	✓	✓	✓

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