YLJ-29007-54813

3 vaccinations 5 coded responses 19 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 080 / NJ
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-25
Survey response — day 7, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site warmth, Pain in extremity, Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: I haven't been able to check in so this is 12 days after the initial shot. After 2 days of real pain in arm, the swelling was still there and is Little but now, but the area around the shot site is all red and itchy... Like after a bee sting, I can feel the actual spot needle went in it is directly hot, but it's itchy like when u have a boo boo healing... I'm just concerned.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Survey response — day 28, dose 1
MedDRA: Gastroenteritis viral, SARS-CoV-2 test — 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: I had a stomach bug yesterday. I went today and got a covid test at Rowan college, then I went to vac site. I explained to Dr's what was going on and they suggested they will reschedule my 2nd shot. They didn't want to over tax immune system.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 28, dose 1
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)
2021-02-17
Dose 2 — Moderna
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Limb discomfort — Feeling: Poor · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness

Free text: Really really really tired and limbs feel heavy... I work in a barn on the weekends and it took all my energy to finish up cleaning the barn and taking care of the horses and other animals

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Discomfort, Limb discomfort, Muscle fatigue — Feeling: Fair · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: My arms feel real heavy... And body just heavy... Not sure of joint pain is part of my normal aches and pains I have but I think it might be a little magnified. The aches are not like flu body aches... It feels like muscle fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 7, dose 2
MedDRA: Limb discomfort, Myalgia — Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: The muscle aches are like my arms are really heavy, not as bad as previously

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-17
Call successful
Participant prefers to complete VAERS report online
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2022-02-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-17	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-10	Successful 2021-07-17	Participant prefers to complete VAERS report online

Free text

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): I haven't been able to check in so this is 12 days after the initial shot. After 2 days of real pain in arm, the swelling was still there and is Little but now, but the area around the shot site is all red and itchy... Like after a bee sting, I can feel the actual spot needle went in it is directly hot, but it's itchy like when u have a boo boo healing... I'm just concerned.

Release 4 — day 28, dose 1

2021-02-10

Symptoms: I had a stomach bug yesterday. I went today and got a covid test at Rowan college, then I went to vac site. I explained to Dr's what was going on and they suggested they will reschedule my 2nd shot. They didn't want to over tax immune system.

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): Really really really tired and limbs feel heavy... I work in a barn on the weekends and it took all my energy to finish up cleaning the barn and taking care of the horses and other animals

2021-02-22

Systemic reaction (other): My arms feel real heavy... And body just heavy... Not sure of joint pain is part of my normal aches and pains I have but I think it might be a little magnified. The aches are not like flu body aches... It feels like muscle fatigue

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): The muscle aches are like my arms are really heavy, not as bad as previously

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	Gastroenteritis viral	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Muscle fatigue	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓

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