Y52-55650-80452

5 vaccinations 15 coded responses 60 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 940 / CA
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Redness, Swelling · Chills

Free text: I have IBD/but hasnt affected it so far

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain, Irritable bowel syndrome — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have IBD so i have abdominal pain/problems all the time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Injected limb mobility decreased, Medical counselling, Pain in extremity — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Severe pain in the injection arm, can not lift or move the arm · Healthcare visit (other): Emailed my symptoms and my healthcare providers office called, she said to ice pack and keep taking Tylenol an I am to check back on Monday, if gets worse go to emergency

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Have been in a lot of pain at my shoulder joint..have not been able to raise my arm at all or use it and its been painful

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

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pain in extremity — Feeling: Good · Site: Pain · Joint pains

Free text: Injection arm is still difficult to raise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
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
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: Rad is on the injection arm but not at the injection site its starts about in inch below the site an goes down my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Lymph nodes under arms and breast are swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema — Feeling: Good · Site: Redness

Free text: The injection arm is still red, but the red area is shrinking in size

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 7, dose 2
MedDRA: Erythema — Feeling: Good · Site: Redness

Free text: Still redness in the injection arm, but red area is getting smaller

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Survey response — day 42, dose 2
MedDRA: Abdominal tenderness, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: A rash on legs, arms and abdomin and abdominal tenderness. Going to call doctor if not better tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-07
Call 2 — Left Voicemail
2021-09-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness

Free text: Lymph nodes in arm pit of the injection site arm are very swollen and painful

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction, Lymphadenopathy — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches

Free text: 'Covid arm' and swollen lymph nodes under arm pit

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-04-04
Dose 4 — Moderna
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-04
Survey response — 3 months, dose 4
MedDRA: Rash — Feeling: Good

Free text: I've had a rash on my chest area

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Dose 5 — Moderna
2022-09-26
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-10-03
Health check-in — day 7, dose 5
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-10-10
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-07
Survey response — day 42, dose 5
MedDRA: Office visit, Thyroid cancer metastatic — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with metastasis thyroid cancer · Healthcare visit (other): In person exam, ultra sound, FNA

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-08
Call 3 — Left Voicemail
2022-11-08
Call 2 — Left Voicemail
2022-12-26
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-28
Survey response — 6 months, dose 5
MedDRA: Condition aggravated, Pre-existing disease, Surgery — 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, Hospitalization

MedDRA releases: 2024-11
2023-03-28
Report sent to call center — 6 months, dose 5
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 · Hospitalization · 1 call case(s)
2023-03-29
Call 1 — Left Voicemail
2023-03-29
Call 1 — Left Voicemail
2023-03-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-10-25	Moderna	No
4	2022-04-04	Moderna	No
5	2022-09-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-05	Unsuccessful
2022-11-07	Unsuccessful
2023-03-28	Unsuccessful

Free text

Release 3 — day 0, dose 1

2021-02-03

Systemic reaction (other): I have IBD/but hasnt affected it so far

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): I have IBD so i have abdominal pain/problems all the time

2021-02-05

Systemic reaction (other): Severe pain in the injection arm, can not lift or move the arm

Healthcare visit (other): Emailed my symptoms and my healthcare providers office called, she said to ice pack and keep taking Tylenol an I am to check back on Monday, if gets worse go to emergency

2021-02-06

Systemic reaction (other): Have been in a lot of pain at my shoulder joint..have not been able to raise my arm at all or use it and its been painful

2021-02-08

Systemic reaction (other): Injection arm is still difficult to raise

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Rad is on the injection arm but not at the injection site its starts about in inch below the site an goes down my arm

2021-03-07

Systemic reaction (other): Lymph nodes under arms and breast are swollen

2021-03-09

Systemic reaction (other): The injection arm is still red, but the red area is shrinking in size

Release 5 — day 7, dose 2

2021-03-10

Systemic reaction (other): Still redness in the injection arm, but red area is getting smaller

Release 7 — day 42, dose 2

2021-04-15

Symptoms: A rash on legs, arms and abdomin and abdominal tenderness. Going to call doctor if not better tomorrow

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Lymph nodes in arm pit of the injection site arm are very swollen and painful

2021-10-28

Systemic reaction (other): 'Covid arm' and swollen lymph nodes under arm pit

Release 12 — 3 months, dose 4

2022-07-04

Symptoms: I've had a rash on my chest area

Release 12 — day 42, dose 5

2022-11-07

Symptoms: Diagnosed with metastasis thyroid cancer

Healthcare visit (other): In person exam, ultra sound, FNA

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	Adverse reaction	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Surgery	·	·	✓
SD	Abdominal tenderness	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SD	Thyroid cancer metastatic	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Irritable bowel syndrome	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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