YSH-54077-11435

5 vaccinations 6 coded responses 25 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 461 / IN
Registered: 2021-01-23

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

2021-01-20
Dose 1 — Moderna
2021-01-23
Registered in v-safe
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling — Feeling: Good

Free text: I had a large red swollen very itchy spot appear on my arm near (not at) the innoculation site. It started to itch on day 8. It continued to grow for about 4 days and then started to go away. The area was about 3x5 inches. Lasted about a w

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 21, dose 1
MedDRA: Erythema, Pruritus — Feeling: Good

Free text: The red welt as disappeared the itching remained for several days.All is clear now. I will get 2nd shot on the 15th, going to have it in other arm!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good · Site: Itching

Free text: No not really, however, the large red itching welt that occurred after the first shot did not occur this time. (I had the injection in the other arm) There was itching and some redness near but not at the injection site. The area was itchy for about 4 days, but it didnt start until about 6 days after I received the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Herpes zoster, Office visit, Stress — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I developed shingles. I doubt it is related to the vaccine, probably stress. Although I have a naturely strong immune system, never get colds, flu, etc. I take no medicines prescription or other. So vaccine connection ???!!! · Healthcare visit (other): Regular appointment.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2021-10-01
Dose 3 — Moderna
2022-02-22
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-02
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Dose 4 — Moderna
2022-09-18
Dose 5 — Moderna
2022-09-20
Survey response — days 1–6 daily, dose 5
MedDRA: Night sweats — Feeling: Good

Free text: The first night after the shot I had big time night sweats. Nothing after that!

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Survey response — days 1–6 daily, dose 5
MedDRA: Herpes zoster — Feeling: Good

Free text: Not from this booster, but I wanted to report that after the first vaccine series I got shingles. I did't connect the shingles with the vaccine until I read where tere had been an increase in Shingles. I have a strong immune system, so it made sens

MedDRA releases: 2024-11 · check-in free text available
2022-09-27
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — day 14, dose 5
Feeling: Good

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

Adult check-in
2022-10-16
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-21
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-22	Moderna
3	2021-10-01	Moderna	No
4	2022-04-04	Moderna	No
5	2022-09-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-26	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-03

Symptoms: I had a large red swollen very itchy spot appear on my arm near (not at) the innoculation site. It started to itch on day 8. It continued to grow for about 4 days and then started to go away. The area was about 3x5 inches. Lasted about a w

Release 4 — day 21, dose 1

2021-02-10

Symptoms: The red welt as disappeared the itching remained for several days.All is clear now. I will get 2nd shot on the 15th, going to have it in other arm!

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): No not really, however, the large red itching welt that occurred after the first shot did not occur this time. (I had the injection in the other arm) There was itching and some redness near but not at the injection site. The area was itchy for about 4 days, but it didnt start until about 6 days after I received the vaccine.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: I developed shingles. I doubt it is related to the vaccine, probably stress. Although I have a naturely strong immune system, never get colds, flu, etc. I take no medicines prescription or other. So vaccine connection ???!!!

Healthcare visit (other): Regular appointment.

Release 12 — days 1–6 daily, dose 5

2022-09-20

Systemic reaction (other): The first night after the shot I had big time night sweats. Nothing after that!

2022-09-21

Systemic reaction (other): Not from this booster, but I wanted to report that after the first vaccine series I got shingles. I did't connect the shingles with the vaccine until I read where tere had been an increase in Shingles. I have a strong immune system, so it made sens cut off by CDC

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	Erythema	✓	✓	✓
SD	Herpes zoster	✓	·	✓
SD	Injection site erythema	·	·	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	○
SD	Injection site swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Stress	✓	·	✓
SRO	Herpes zoster	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Night sweats	·	·	✓

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