Z57-28440-92801

3 vaccinations 10 coded responses 34 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 760 / TX
Registered: 2021-01-28

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair

Free text: Gland in armpit of injected arm is swollen and painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair

Free text: Swollen armpit gland on same arm as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — day 7, dose 1
MedDRA: Injection site pain, Injection site swelling — Feeling: Good

Free text: Swollen and painful gland in armpit of same arm that was injected

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Fair

Free text: Just a headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair

Free text: Swollen lymph node on left arm out, side of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 28, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymph node swollen in left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Good

Free text: Random headache on one side of head that shoots down face, and soon disappears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Migraine with aura — Feeling: Good · 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, Emergency room or emergency department visit

Free text: Migraine aura without headache 8/21/21

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
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)
2021-09-01
Call 1 — Left Voicemail
2021-11-26
Dose 3 — Moderna
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fever · None

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Survey response — day 14, dose 3
MedDRA: Cheilitis, Rash erythematous — Feeling: Fair

Free text: Red bumps around inside of lips

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — day 42, dose 3
MedDRA: COVID-19, Medical counselling — 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

Free text: Symptoms: Covid positive · Healthcare visit (other): Email

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Report sent to call center — day 42, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-01-11
Call 1 — Could Not Reach Participant
2022-01-14
Call 2 — Could Not Reach Participant
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-11-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-28	Unsuccessful
2022-01-07	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): Gland in armpit of injected arm is swollen and painful

2021-02-03

Systemic reaction (other): Swollen armpit gland on same arm as injection

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): Swollen and painful gland in armpit of same arm that was injected

Release 4 — day 21, dose 1

2021-02-18

Symptoms: Just a headache

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Swollen lymph node on left arm out, side of injection

Release 6 — day 28, dose 2

2021-03-27

Symptoms: Lymph node swollen in left arm

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Random headache on one side of head that shoots down face, and soon disappears

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Migraine aura without headache 8/21/21

Release 10 — day 14, dose 3

2021-12-10

Symptoms: Red bumps around inside of lips

Release 10 — day 42, dose 3

2022-01-07

Symptoms: Covid positive

Healthcare visit (other): Email

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	Medical counselling	·	·	✓
SD	Cheilitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Migraine with aura	✓	·	✓
SD	Rash erythematous	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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