Y76-24787-97071

2 vaccinations 12 coded responses 21 check-ins 12 free-text entries 6 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 201 / VA
Registered: 2021-03-15

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

2021-03-10
Dose 1 — Moderna
2021-03-15
Registered in v-safe
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Acne, Rash — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: A rash on my face. Started as a pimple on day 3 and its a small rash now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Survey response — day 7, dose 1
MedDRA: Burning sensation, Erythema, Rash — Feeling: Good · Rash, not including the immediate area around the injection site · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I continue to have a rash on my right face cheek and redness and burning on both cheeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 7, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 21, dose 1
MedDRA: Cough, Pre-existing disease, Rosacea, Scar — Feeling: Good

Free text: I still have a light cough that started to be consistent after vaccination. It is not worse but its consistent. Also I have a scar on my right cheek from a rosacea flare up that happened after vaccination. I have never had a flare up previously.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Fatigue, Gait disturbance — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Cough, very fatigued, hard time walking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Nasal discomfort, Nasal pruritus, Pruritus — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Allergic like symptoms (itchy nose, face) redness in my face where I had a flare out with vaccine shot number 1. Never quite went back to normal. Weird sensation in my right nose nostril.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Fatigue, Hypersensitivity, Nasal discomfort, Paranasal sinus discomfort, Rosacea — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work

Free text: A feeling that there is something in my left nostril, allergic feelings, sinus pressure in the face, rosacea red face in area that flared up in with first shot. Overal felt more tired today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Ringing in my right ear last 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 14, dose 2
MedDRA: Pain, Rash macular, Skin discolouration — Feeling: Good

Free text: I have noticed since first vaccine one of the sun spots/aging spots on my neck got darker. Since the second vaccine it has gotten itchier and thicker. If I scratch it, I feel some pain and stinging in the area. I need to show it to a Dermatologist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 21, dose 2
MedDRA: Condition aggravated, Pain of skin, Pre-existing disease, Pruritus, Solar lentigo, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I have a dermatologist appointment to check the aging spot on my neck that has been itchy and a little painful and has become darker and thicker since my vaccine 1 and 2. In general I feel more itchy since vaccination on body and face. · Healthcare visit (other): Appointment is next week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Survey response — day 28, dose 2
MedDRA: Ear pruritus, Office visit, Skin discolouration, Tinnitus, Unevaluable event — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: A high pitch ringing in my left ear. I have a doctors appointment this week to check the spot on my neck with itching and my ear. · Healthcare visit (other): My doctor visits are Wed and Thursday this week. I have not gone yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — day 28, 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)
2021-05-18
Survey response — day 35, dose 2
MedDRA: Headache, Neck pain, Ocular discomfort, Tinnitus — Feeling: Poor · 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: Ear ringing and very bad headaches. Neck pain and eye discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 35, 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)
2021-05-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Survey response — 6 months, dose 2
MedDRA: General physical health deterioration, Myalgia, Pre-existing disease, Rosacea, Sensitive skin, Tinnitus — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear ringing continues. Sensitive skin, Rosa flare ups face and neck. Muscular pain Overall worse health

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-14
Call successful
Participant prefers to complete VAERS report online
2022-04-15
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-13	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-16	Successful	Participant prefers to complete VAERS report online
2021-03-17	Successful	Participant prefers to complete VAERS report online
2021-05-04	Successful	Participant prefers to complete VAERS report online
2021-05-11	Successful	Participant prefers to complete VAERS report online
2021-05-18	Successful	Participant prefers to complete VAERS report online
2021-10-12	Successful 2021-10-14	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): A rash on my face. Started as a pimple on day 3 and its a small rash now.

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): I continue to have a rash on my right face cheek and redness and burning on both cheeks.

Release 6 — day 21, dose 1

2021-03-31

Symptoms: I still have a light cough that started to be consistent after vaccination. It is not worse but its consistent. Also I have a scar on my right cheek from a rosacea flare up that happened after vaccination. I have never had a flare up previously.

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Cough, very fatigued, hard time walking

2021-04-15

Systemic reaction (other): Allergic like symptoms (itchy nose, face) redness in my face where I had a flare out with vaccine shot number 1. Never quite went back to normal. Weird sensation in my right nose nostril.

2021-04-16

Systemic reaction (other): A feeling that there is something in my left nostril, allergic feelings, sinus pressure in the face, rosacea red face in area that flared up in with first shot. Overal felt more tired today.

Release 7 — day 7, dose 2

2021-04-22

Systemic reaction (other): Ringing in my right ear last 3 days

Release 8 — day 14, dose 2

2021-04-27

Symptoms: I have noticed since first vaccine one of the sun spots/aging spots on my neck got darker. Since the second vaccine it has gotten itchier and thicker. If I scratch it, I feel some pain and stinging in the area. I need to show it to a Dermatologist. cut off by CDC

Release 8 — day 21, dose 2

2021-05-04

Symptoms: I have a dermatologist appointment to check the aging spot on my neck that has been itchy and a little painful and has become darker and thicker since my vaccine 1 and 2. In general I feel more itchy since vaccination on body and face.

Healthcare visit (other): Appointment is next week.

Release 8 — day 28, dose 2

2021-05-11

Symptoms: A high pitch ringing in my left ear. I have a doctors appointment this week to check the spot on my neck with itching and my ear.

Healthcare visit (other): My doctor visits are Wed and Thursday this week. I have not gone yet.

Release 8 — day 35, dose 2

2021-05-18

Symptoms: Ear ringing and very bad headaches. Neck pain and eye discomfort

Release 10 — 6 months, dose 2

2021-10-12

Symptoms: Ear ringing continues. Sensitive skin, Rosa flare ups face and neck. Muscular pain Overall worse health

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	○	✓	○
HCVO	Unevaluable event	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Ear pruritus	✓	·	✓
SD	General physical health deterioration	·	·	✓
SD	Headache	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Ocular discomfort	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain of skin	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Rosacea	✓	✓	✓
SD	Scar	✓	✓	✓
SD	Sensitive skin	·	·	✓
SD	Skin discolouration	✓	✓	✓
SD	Solar lentigo	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Acne	·	·	✓
SRO	Burning sensation	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Nasal discomfort	✓	✓	✓
SRO	Nasal pruritus	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rosacea	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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