Y8W-10103-08746

7 vaccinations 24 coded responses 79 check-ins 21 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 078 / NJ
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-18
Survey response — day 14, dose 1
MedDRA: Injection site pain, Injection site rash, Injection site swelling — Feeling: Good

Free text: 8 days after my vaccine, I developed a bump at the site, minor pain and a rash. The bump and the pain did not last long. The rash lingered but got better. Its barely visible now. Would like to speak with someone on this if possible. Thank you!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 21, dose 1
MedDRA: Injection site erythema, Injection site rash, Injection site reaction, Rash erythematous — Feeling: Fair

Free text: Rash at injection site disappeared and then reappeared again. Its very light now though. Sort of a large, light red blotch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-01
Survey response — day 0, dose 2
MedDRA: Back pain — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities

Free text: Chronic back pain (unrelated to vaccine)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Free text: Yellowish bruise at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Stop get random pain in left arm which was injection site of my first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-28
Dose 3 — Moderna
2021-08-28
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-08-29
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-08-31
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Burning sensation at the injection site. Brief but intense.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-03
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Why is Rochelle Wallensky so bad at her job?

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-07
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-09-11
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-09-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-09-25
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-10-02
Survey response — day 35, dose 3
MedDRA: Office visit, Postmenopause, Vaginal haemorrhage — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Vaginal bleeding post menopause · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-09
Survey response — day 42, dose 3
MedDRA: Office visit, Postmenopausal haemorrhage — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Post menopausal bleeding. I'm sure it's not vaccine related but that's what has changed. · Healthcare visit (other): Office visit; tests scheduled

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-10-13
Call 1 — Left Voicemail
2021-11-29
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-01-15
Dose 4 — Moderna
2022-01-15
Health check-in — day 0, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-16
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-17
Survey response — days 1–6 daily, dose 4
MedDRA: Body temperature increased — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Low grade fever (highest 99.5) lasted from late afternoon on 1/15 through about 6am on Monday morning 1/17. Started to dissipate by late AM on Monday.

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-22
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-29
Survey response — day 14, dose 4
MedDRA: Cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Random bronchitis type cough.

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-02-19
Health check-in — day 35, dose 4
Feeling: Poor

Adult check-in
2022-02-26
Survey response — day 42, dose 4
MedDRA: Dysphagia, Feeding disorder, Lymphadenopathy, Office visit, Oropharyngeal pain, Sinusitis — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection, severe gland swelling, sore throat, inability to chew or swallow. · Healthcare visit (other): Private physician office

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-01
Call 1 — Left Voicemail
2022-07-12
Dose 5 — Moderna
2022-07-13
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-07-14
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-15
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-07-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-07-19
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-26
Health check-in — day 14, dose 5
Feeling: Poor

Adult check-in
2022-08-02
Survey response — day 21, dose 5
MedDRA: Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Body aches

MedDRA releases: 2024-11 · check-in free text available
2022-08-09
Survey response — day 28, dose 5
MedDRA: Back pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

Free text: Pain in my left arm, more pain in my lower back.

MedDRA releases: 2024-11 · check-in free text available
2022-08-16
Survey response — day 35, dose 5
MedDRA: Contusion, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bruises and pain on and in my left arm.

MedDRA releases: 2024-11 · check-in free text available
2022-08-23
Survey response — day 42, dose 5
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lower back pain

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Dose 6 — Moderna
2022-09-24
Health check-in — day 0, dose 6
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 6
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2022-09-29
Survey response — days 1–6 daily, dose 6
MedDRA: Immunisation reaction, Injection site rash, Rash, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still have a rash at the injection site. This seems to be consistent with all of my vaccine doses, both primary series and boosters. It started with the "Moderna arm", when I developed a rash and swelling several days after my first shot.

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — days 1–6 daily, dose 6
MedDRA: Injection site rash — Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Still have a large rash around injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — day 7, dose 6
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-08
Health check-in — day 14, dose 6
Feeling: Fair

Adult check-in
2022-10-16
Health check-in — day 21, dose 6
Feeling: Fair

Adult check-in
2022-10-22
Survey response — day 28, dose 6
MedDRA: Back pain, Ear pain, Muscular weakness — Feeling: Fair · 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: Worsening back pain and left ear pain. Leg weakness.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — day 28, dose 6
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-26
Call 1 — Left Voicemail
2022-10-29
Health check-in — day 35, dose 6
Feeling: Fair

Adult check-in
2022-11-05
Health check-in — day 42, dose 6
Feeling: Fair

Adult check-in
2023-03-25
Health check-in — 6 months, dose 6
Feeling: Good

Adult check-in
2023-04-22
Dose 7 — Moderna
2023-04-22
Survey response — day 0, dose 7
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-24
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-04-25
Health check-in — days 1–6 daily, dose 7
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2023-04-27
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Site: Redness · Joint pains

Adult check-in
2023-04-28
Health check-in — days 1–6 daily, dose 7
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2023-04-29
Health check-in — day 7, dose 7
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2023-05-06
Health check-in — day 14, dose 7
Feeling: Fair

Adult check-in
2023-05-14
Health check-in — day 21, dose 7
Feeling: Fair

Adult check-in
2023-05-20
Survey response — day 28, dose 7
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-27
Health check-in — day 35, dose 7
Feeling: Fair

Adult check-in
2023-06-03
Survey response — day 42, dose 7
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-08-28	Moderna	No
4	2022-01-15	Moderna	No
5	2022-07-12	Moderna	No
6	2022-09-24	Moderna	No
7	2023-04-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-02	Unsuccessful
2021-10-09	Unsuccessful
2022-02-26	Unsuccessful
2022-10-22	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Dizziness

Release 5 — day 14, dose 1

2021-03-18

Symptoms: 8 days after my vaccine, I developed a bump at the site, minor pain and a rash. The bump and the pain did not last long. The rash lingered but got better. Its barely visible now. Would like to speak with someone on this if possible. Thank you!

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Rash at injection site disappeared and then reappeared again. Its very light now though. Sort of a large, light red blotch.

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): Chronic back pain (unrelated to vaccine)

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Yellowish bruise at injection site.

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): Stop get random pain in left arm which was injection site of my first dose.

Release 9 — days 1–6 daily, dose 3

2021-08-29

Systemic reaction (other): Dizziness

2021-08-31

Systemic reaction (other): Burning sensation at the injection site. Brief but intense.

2021-09-03

Systemic reaction (other): Why is Rochelle Wallensky so bad at her job?

Release 9 — day 35, dose 3

2021-10-02

Symptoms: Vaginal bleeding post menopause

Healthcare visit (other): Office visit

Release 10 — day 42, dose 3

2021-10-09

Symptoms: Post menopausal bleeding. I'm sure it's not vaccine related but that's what has changed.

Healthcare visit (other): Office visit; tests scheduled

Release 10 — days 1–6 daily, dose 4

2022-01-17

Systemic reaction (other): Low grade fever (highest 99.5) lasted from late afternoon on 1/15 through about 6am on Monday morning 1/17. Started to dissipate by late AM on Monday.

Release 11 — day 14, dose 4

2022-01-29

Symptoms: Random bronchitis type cough.

Release 11 — day 42, dose 4

2022-02-26

Symptoms: Sinus infection, severe gland swelling, sore throat, inability to chew or swallow.

Healthcare visit (other): Private physician office

Release 12 — day 21, dose 5

2022-08-02

Symptoms: Body aches

Release 12 — day 28, dose 5

2022-08-09

Symptoms: Pain in my left arm, more pain in my lower back.

Release 12 — day 35, dose 5

2022-08-16

Symptoms: Bruises and pain on and in my left arm.

Release 12 — day 42, dose 5

2022-08-23

Symptoms: Lower back pain

Release 12 — days 1–6 daily, dose 6

2022-09-29

Systemic reaction (other): Still have a rash at the injection site. This seems to be consistent with all of my vaccine doses, both primary series and boosters. It started with the "Moderna arm", when I developed a rash and swelling several days after my first shot.

2022-09-30

Systemic reaction (other): Still have a large rash around injection site.

Release 12 — day 28, dose 6

2022-10-22

Symptoms: Worsening back pain and left ear pain. Leg weakness.

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	Back pain	·	·	✓
SD	Contusion	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dysphagia	·	·	✓
SD	Ear pain	·	·	✓
SD	Feeding disorder	·	·	✓
SD	Injection site erythema	✓	✓	○
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site reaction	·	·	✓
SD	Injection site swelling	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Postmenopausal haemorrhage	·	·	✓
SD	Postmenopause	·	·	✓
SD	Rash erythematous	·	·	✓
SD	Sinusitis	·	·	✓
SD	Vaginal haemorrhage	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Body temperature increased	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site pain	✓	·	✓
SRO	Injection site rash	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Swelling	·	·	✓
SRO	Unevaluable event	✓	·	✓

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