Z7A-32558-70103

3 vaccinations 9 coded responses 29 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 446 / OH
Registered: 2021-03-22

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
2021-03-22
Registered in v-safe
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-03-27
Survey response — day 14, dose 1
MedDRA: Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Vaccination site reaction — Feeling: Fair

Free text: A sudden flare up around the injection site after it had healed completely had no swelling,pain or heat. I had 3 days of that. Then on the 9th day post shot it started to swell,tender to touch w/ heat site also felt lumpy. 24 hrs later all fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
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: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Neuralgia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Both ears around the opening intensly feels like every nerve is on fire and a lot of pressure. Happened with first shot too

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Free text: The arm of the injection has moderate muscle pain down the bicep and into the side of the forearm.

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: Pain in extremity — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches

Free text: Still the pain in my upper forearm about half way up from the wrist

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: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-17
Survey response — day 7, dose 2
MedDRA: Ear discomfort, Ear pruritus, Pruritus — Feeling: Good · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: The opening of both ear holes are intensely itching at the same time on and off throughout the day

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

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Lymphadenopathy, Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Constant swelling of the glands under my chin. This week has been the worst pain since it started · Healthcare visit (other): Actaul visit to the doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-20
Call 1 — Left Voicemail
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Fever · Headache

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-22
Survey response — day 28, dose 3
MedDRA: Arthralgia, Cough, Fatigue, Malaise — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dry cough, malaise, sore joints, and tiredness

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Survey response — day 42, dose 3
MedDRA: Arthralgia, Cough, Headache, Malaise, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Malaise, congestion, headache, coughing, sore joints.

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Cough, Medical counselling, Productive cough, Pruritus, Respiratory tract infection, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Suffered from two differnt respiratory illnesses both with a lingering cough. This last cough has lasted nearly 30 days and currently coughing w/ phlegm. As well as very odd like hives on one leg that itch so intensly they have come & gone 3 times. · Healthcare visit (other): The doctor visited me while i was sitting in the car. Car visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-28
Call 1 — Left Voicemail
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-25
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna
3	2021-10-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-10	Unsuccessful
2022-01-26	Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-03-27

Symptoms: A sudden flare up around the injection site after it had healed completely had no swelling,pain or heat. I had 3 days of that. Then on the 9th day post shot it started to swell,tender to touch w/ heat site also felt lumpy. 24 hrs later all fine.

Release 7 — days 1–6 daily, dose 2

2021-04-12

Systemic reaction (other): Both ears around the opening intensly feels like every nerve is on fire and a lot of pressure. Happened with first shot too

2021-04-14

Systemic reaction (other): The arm of the injection has moderate muscle pain down the bicep and into the side of the forearm.

2021-04-15

Systemic reaction (other): Still the pain in my upper forearm about half way up from the wrist

Release 7 — day 7, dose 2

2021-04-17

Systemic reaction (other): The opening of both ear holes are intensely itching at the same time on and off throughout the day

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Constant swelling of the glands under my chin. This week has been the worst pain since it started

Healthcare visit (other): Actaul visit to the doctor

Release 10 — day 28, dose 3

2021-11-22

Symptoms: Dry cough, malaise, sore joints, and tiredness

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Malaise, congestion, headache, coughing, sore joints.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Suffered from two differnt respiratory illnesses both with a lingering cough. This last cough has lasted nearly 30 days and currently coughing w/ phlegm. As well as very odd like hives on one leg that itch so intensly they have come & gone 3 times. cut off by CDC

Healthcare visit (other): The doctor visited me while i was sitting in the car. Car visit

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	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Pain	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Pruritus	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	Urticaria	·	·	✓
SD	Vaccination site reaction	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear pruritus	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	○

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