YAD-77027-06296

3 vaccinations 14 coded responses 36 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 906 / CA
Registered: 2021-01-23

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

2021-01-22
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Immediate post-injection reaction, Pain in extremity, Throat irritation — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: I didnt have any reactions in the 15 minutes after the shot but about 20 after I was ok to go I had a slightly itchy throat and a slight cough that lasted for about 1.5-2 hours. Nothing since then but a sore arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Injection site rash — Feeling: Fair

Free text: Rash around and below injection site. No itching or bumps just a rash that spread sideways across upper left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 21, dose 1
MedDRA: Cough — Feeling: Fair

Free text: Slight cough. I dont know if its related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-21
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have swelling under my left arm. Same arm I got the shot in. Started 2 days after the shot and I still have a little left. Was painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Headache

Free text: Still have swelling in lymph node area under same arm as the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — day 7, dose 2
MedDRA: Oedema peripheral — Feeling: Good · Headache

Free text: Tiny bit of swelling under left arm still.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-05-23
Survey response — 3 months, dose 2
MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Survey response — 6 months, dose 2
MedDRA: Cough, Wheezing — Feeling: Fair

Free text: Just recently developed a cough. And a tiny bit of wheezing.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-09
Dose 3 — Moderna
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Swelling in armpit

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Still have underarm swelling

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches · Be unable to work or attend school

Adult check-in
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: More swelling in the underarm area

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-12-18
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-13
Survey response — day 35, dose 3
MedDRA: Asthma, Fatigue, Headache, Nasal congestion, Pain in extremity, Swelling — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shingles vaccine last week. Pain in arm, headache, swelling, tiredness. Have also had nasal congestion and some asthma like symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Survey response — day 42, dose 3
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-03-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-14
Call 1 — Left Voicemail
2022-06-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-09
Survey response — 12 months, dose 3
MedDRA: Dizziness, Rhinorrhoea — Feeling: Fair

Free text: Runny nose. Dizziness that went away after a few days

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-21	Moderna
3	2021-12-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-23	Unsuccessful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): I didnt have any reactions in the 15 minutes after the shot but about 20 after I was ok to go I had a slightly itchy throat and a slight cough that lasted for about 1.5-2 hours. Nothing since then but a sore arm.

Release 3 — day 14, dose 1

2021-02-05

Symptoms: Rash around and below injection site. No itching or bumps just a rash that spread sideways across upper left arm

Release 4 — day 21, dose 1

2021-02-12

Symptoms: Slight cough. I dont know if its related.

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): I have swelling under my left arm. Same arm I got the shot in. Started 2 days after the shot and I still have a little left. Was painful.

2021-02-27

Systemic reaction (other): Still have swelling in lymph node area under same arm as the shot

Release 4 — day 7, dose 2

2021-02-28

Systemic reaction (other): Tiny bit of swelling under left arm still.

Release 8 — 3 months, dose 2

2021-05-23

Symptoms: Bronchitis

Release 9 — 6 months, dose 2

2021-08-24

Symptoms: Just recently developed a cough. And a tiny bit of wheezing.

Release 10 — days 1–6 daily, dose 3

2021-12-10

Systemic reaction (other): Swelling in armpit

2021-12-11

Systemic reaction (other): Still have underarm swelling

2021-12-13

Systemic reaction (other): More swelling in the underarm area

Release 10 — day 35, dose 3

2022-01-13

Symptoms: Shingles vaccine last week. Pain in arm, headache, swelling, tiredness. Have also had nasal congestion and some asthma like symptoms

Release 10 — day 42, dose 3

2022-01-20

Symptoms: Cough

Release 12 — 12 months, dose 3

2022-12-09

Symptoms: Runny nose. Dizziness that went away after a few days

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	Asthma	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site rash	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Swelling	·	·	✓
SD	Wheezing	✓	·	✓
SRO	Cough	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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