Z5W-29099-25832

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 302 / GA
Registered: 2021-02-01

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-01
Registered in v-safe
2021-02-01
Dose 1 — Moderna
2021-02-01
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Just sore where the Moderna shot was administered. Its mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: The left arm is still a little sore but getting better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain

Free text: Minor pain where the injection site was administered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Haematuria — Feeling: Fair · Fatigue or tiredness

Free text: Hematuria this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — day 7, dose 1
MedDRA: Back pain, Urinary tract infection — Feeling: Fair · Site: Pain · Nausea

Free text: Low back pain due to UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Itching · Nausea

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Free text: My left arm swelled up somewhat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tiredness

Free text: My arm is better today than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: Left arm still is swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Left arm still a little sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Gastroenteritis viral, Labyrinthitis, Paranasal sinus hypersecretion — 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 · Outpatient clinic or urgent care clinic visit

Free text: Inner ear infection with sinus draining was on antibiotics ears are better but gotten a stomach virus that lm trying to get over

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
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

1 call case(s)
2021-09-07
Call 1 — Left Voicemail
2022-03-01
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-08-30	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Just sore where the Moderna shot was administered. Its mild

2021-02-04

Systemic reaction (other): The left arm is still a little sore but getting better

2021-02-05

Systemic reaction (other): Minor pain where the injection site was administered

2021-02-07

Systemic reaction (other): Hematuria this morning

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Low back pain due to UTI

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): My left arm swelled up somewhat

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): My arm is better today than yesterday

2021-03-04

Systemic reaction (other): Left arm still is swollen

Release 5 — day 7, dose 2

2021-03-08

Systemic reaction (other): Left arm still a little sore

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Inner ear infection with sinus draining was on antibiotics ears are better but gotten a stomach virus that lm trying to get over

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	Labyrinthitis	✓	·	✓
SD	Paranasal sinus hypersecretion	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Haematuria	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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