Z4A-27619-71682

2 vaccinations 8 coded responses 19 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 027 / MA
Registered: 2021-03-24

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

2021-03-13
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Survey response — day 7, dose 1
MedDRA: Chills, Cough, Dyspnoea, Ear pain, Headache, Injection site pruritus, Lymph node pain, Lymphadenopathy, Medical counselling, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: 5 days after vaccine, fever was 103.1 with chills, body aches, severe headache. Day 6 was spent mostly sleeping, coughing, severe headache, sore throat, earache. Day 7 I took 2 covid test, one self administered and one done at clinic. Both test are negative. Day 8 itch started at injection site and lymph nodes started hurting. The pain has increased, tender to touch, and swollen. The lymph nodes are on same side of injection site and in neck and collar bone area. Shortness of breath started on day 5 with the high fever. Doctor has prescribed Robitusin for cough, steroid inhaler (my rescue inhaler was not helping at all), Tylenol and Advil for pain and inflammation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 7, 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)
2021-03-27
Survey response — day 14, dose 1
MedDRA: Back pain, Lymph node pain, Neck pain, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in lymph nodes increased/moved. Still in neck and pillar one but has travelled to rear upper to mid back · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 14, 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)
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches, 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
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dehydration, Dry mouth, Oropharyngeal pain — Feeling: Good · Site: Pain, Redness, Itching · Headache

Free text: Sore throat and very dry/dehydrated. Cant seem to drink enough water. Causes coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia, Rash — Feeling: Good · Site: Redness, Itching

Free text: Slight rash, pins and needles on upper lip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Oral pruritus, Paraesthesia oral — Feeling: Good · Site: Itching

Free text: Little itch, tingling in upper lip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — day 28, dose 2
MedDRA: Headache, Lymph node pain — Feeling: Good

Free text: I get frequent headaches that are not usual for me. Much more intense. I also have been getting more pain in my lymph nodes. It comes and goes rather quickly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-11
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-27	Successful 2022-03-08	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): 5 days after vaccine, fever was 103.1 with chills, body aches, severe headache. Day 6 was spent mostly sleeping, coughing, severe headache, sore throat, earache. Day 7 I took 2 covid test, one self administered and one done at clinic. Both test are negative. Day 8 itch started at injection site and lymph nodes started hurting. The pain has increased, tender to touch, and swollen. The lymph nodes are on same side of injection site and in neck and collar bone area. Shortness of breath started on day 5 with the high fever. Doctor has prescribed Robitusin for cough, steroid inhaler (my rescue inhaler was not helping at all), Tylenol and Advil for pain and inflammation.

Release 6 — day 14, dose 1

2021-03-27

Symptoms: Pain in lymph nodes increased/moved. Still in neck and pillar one but has travelled to rear upper to mid back

Healthcare visit (other): Doctors office

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Dizziness

2021-04-12

Systemic reaction (other): Sore throat

2021-04-13

Systemic reaction (other): Sore throat and very dry/dehydrated. Cant seem to drink enough water. Causes coughing

2021-04-14

Systemic reaction (other): Slight rash, pins and needles on upper lip

2021-04-15

Systemic reaction (other): Little itch, tingling in upper lip

Release 8 — day 28, dose 2

2021-05-08

Symptoms: I get frequent headaches that are not usual for me. Much more intense. I also have been getting more pain in my lymph nodes. It comes and goes rather quickly.

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	Headache	✓	✓	✓
SD	Lymph node pain	✓	✓	✓
SD	Neck pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Oral pruritus	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓

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