Y5L-18415-80653

5 vaccinations 7 coded responses 20 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 185 / PA
Registered: 2021-03-18

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

2021-02-19
Dose 1 — Moderna
2021-03-18
Registered in v-safe
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site swelling — Feeling: Poor · Site: Pain, Redness, 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: Swelling near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Swollen lymph node arm pit of vaccinated arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site

Free text: Still swollen in my arm pit red just below injection site and also below underarm swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Office visit, Pain in extremity — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mild pain in arm pit where it is still swollen but has gone down a lot. · Healthcare visit (other): My doctor is setting up an ultra sound for under arm and blood work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Swelling — Feeling: Good · Site: Swelling

Free text: Swelling and rash is going down and almost gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-31
Dose 3 — Moderna
Co-administered: Flu
2022-01-07
Call successful
Does not wish to fill out VAERS report
2022-04-10
Dose 4 — Moderna
2022-10-02
Dose 5 — Moderna
Co-administered: Flu
2022-10-11
Survey response — day 7, dose 5
MedDRA: Chills, Injection site erythema, Injection site pain, Injection site warmth — Feeling: Good

Free text: Not today but the day of my moderna shot i did have large redness and it felt hot to touch, pain arount the injection area. Got the shot 10/2/2022 all lasted for 3 days but only had chills after day 1. Im great now.

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-06
Survey response — day 35, dose 5
MedDRA: Bronchitis, Office visit, Pneumonia, Pre-existing disease — 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

Free text: Symptoms: bronchitis/ lung infection ... i have asthma so it hits me hard. · Healthcare visit (other): Doctors office

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Report sent to call center — day 35, 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

1 call case(s)
2022-11-07
Call 1 — Left Voicemail
2022-11-13
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-10-31	Moderna	Flu
4	2022-04-10	Moderna	No
5	2022-10-02	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Successful 2022-01-07	Does not wish to fill out VAERS report
2022-11-06	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Swelling near injection site

2021-03-21

Systemic reaction (other): Swollen lymph node arm pit of vaccinated arm

2021-03-22

Systemic reaction (other): Still swollen in my arm pit red just below injection site and also below underarm swelling

2021-03-23

Systemic reaction (other): Mild pain in arm pit where it is still swollen but has gone down a lot.

Healthcare visit (other): My doctor is setting up an ultra sound for under arm and blood work

2021-03-24

Systemic reaction (other): Swelling and rash is going down and almost gone.

Release 12 — day 7, dose 5

2022-10-11

Systemic reaction (other): Not today but the day of my moderna shot i did have large redness and it felt hot to touch, pain arount the injection area. Got the shot 10/2/2022 all lasted for 3 days but only had chills after day 1. Im great now.

Release 12 — day 35, dose 5

2022-11-06

Symptoms: bronchitis/ lung infection ... i have asthma so it hits me hard.

Healthcare visit (other): Doctors office

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	Bronchitis	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Chills	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Swelling	✓	✓	✓

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