Z2V-88577-06339

4 vaccinations 4 coded responses 29 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 983 / WA
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-01
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · 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 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site rash, Injection site scab, Injection site swelling, Rash papular — Feeling: Good

Free text: I got Covid arm on the 8th day after my Moderna vaccine. I had swelling and a raised rash around the site of the injection, about 4 x 4 in size. The actual site of the injection was visible with a small red scab the size of a pinprick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-30
Dose 2 — Moderna
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-05-07
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-05-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — day 42, dose 2
MedDRA: Aphthous ulcer, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Canker sores started developing in my mouth three weeks ago and have spread throughout my mouth and tongue. The last week has been extremely painful. I had to see my dentist for a prescription. Ive never had canker sores in my life until now. · Healthcare visit (other): My dentists office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call 1 — Left Voicemail
2021-08-01
Survey response — 3 months, dose 2
MedDRA: Malignant melanoma — Feeling: Fair

Free text: Diagnosis of melanoma

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-30
Survey response — 6 months, dose 2
MedDRA: Cancer surgery, Malignant melanoma, Skin graft — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Melanoma · Healthcare visit (other): Surgery for removal of cancer and surgery for skin graft

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2021-11-02
Call 1 — Left Voicemail
2021-12-04
Dose 3 — Moderna
2022-05-25
Dose 4 — Moderna
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-01
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-30	Moderna
3	2021-12-04	Moderna	No
4	2022-05-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-11	Unsuccessful
2021-10-30	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-15

Symptoms: I got Covid arm on the 8th day after my Moderna vaccine. I had swelling and a raised rash around the site of the injection, about 4 x 4 in size. The actual site of the injection was visible with a small red scab the size of a pinprick.

Release 9 — day 42, dose 2

2021-06-11

Symptoms: Canker sores started developing in my mouth three weeks ago and have spread throughout my mouth and tongue. The last week has been extremely painful. I had to see my dentist for a prescription. Ive never had canker sores in my life until now.

Healthcare visit (other): My dentists office

Release 9 — 3 months, dose 2

2021-08-01

Symptoms: Diagnosis of melanoma

Release 10 — 6 months, dose 2

2021-10-30

Symptoms: Melanoma

Healthcare visit (other): Surgery for removal of cancer and surgery for skin graft

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	Cancer surgery	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Skin graft	·	·	✓
SD	Aphthous ulcer	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site scab	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Malignant melanoma	✓	·	✓
SD	Rash papular	✓	✓	✓

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