Z8J-26376-75527

3 vaccinations 8 coded responses 20 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 280 / NC
Registered: 2021-02-12

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

2021-02-03
Dose 1 — Moderna
2021-02-12
Registered in v-safe
2021-02-12
Survey response — day 7, dose 1
MedDRA: Asthenia, Discomfort, Erythema, Feeling hot, Headache, Induration, Injection site reaction, Nodule, Pruritus, Sleep disorder, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Be unable to do your normal daily activities

Free text: I had a red raised area 2 days after the vaccine. The heat and redness went away around tuesday. I have a hard knot but it was not painful. Yesterday it started itching and it red again hot again. This is the side I sleep on so it was uncomfortable. I slept with a cold pack on it until the cold pack thawed. Had a off and on dull headache and slight weakness for about 5 days. Did not need tylenol. I have felt fairly fine other than injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Pain in extremity, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache

Free text: Temperature has fluctuated during the day. Have a dull headache. Arm sore. But have completed all daily activities without any issue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Immunisation reaction, Pre-existing disease — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever

Free text: Felt bad this morning, feeling much better this afternoon. However, it appears I am developing the covid arm as I did with first shot. I believe it is just my sensitive skin and genetic makeup and allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Was extremely tired last night. Went to bed at 8 slept 10 hours. Felt fine when I woke up. Just seem to need a little more rest past few days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 14, dose 2
MedDRA: Headache, Limb discomfort — Feeling: Good

Free text: Occasionally I have the dull headache like I did right after both vaccines. Still have some soreness in my left arm where I got 1st dose and developed the covid arm. Right arm where I had 2nd dose feels fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 21, dose 2
MedDRA: Breast pain — Feeling: Good

Free text: Sore breasts for one week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Survey response — 3 months, dose 2
MedDRA: Breast pain, Menopausal symptoms, Peripheral swelling — Feeling: Good

Free text: Left arm swelled w 1st shot, after 2nd shot. Breasts were full. Had some breasr underarm soreness for about 2 weeks. Was also taking provera for menapause issues. Soreness has gone away now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-13
Dose 3 — Moderna
Co-administered: Flu
2021-10-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-14
Survey response — 6 months, dose 3
MedDRA: Bronchitis, COVID-19, Fatigue, Influenza virus test negative, Office visit, Patient isolation, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor · 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

Free text: Had Covid 2/7 very mild stayed home 5 days. March 3rd developed Bronchitis. Took Steroids and inhaler and was fine. Friday March 12 was tired and woke up sat with congestion. Saw Dr today. Neg. flu &Covid.bad congestion but lungs clear. Guafison w co

MedDRA releases: 2024-11 · check-in free text available
2022-03-14
Report sent to call center — 6 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-09-13	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-03-14	Unsuccessful

Free text

Release 4 — day 7, dose 1

2021-02-12

Systemic reaction (other): I had a red raised area 2 days after the vaccine. The heat and redness went away around tuesday. I have a hard knot but it was not painful. Yesterday it started itching and it red again hot again. This is the side I sleep on so it was uncomfortable. I slept with a cold pack on it until the cold pack thawed. Had a off and on dull headache and slight weakness for about 5 days. Did not need tylenol. I have felt fairly fine other than injection site.

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Temperature has fluctuated during the day. Have a dull headache. Arm sore. But have completed all daily activities without any issue.

2021-03-05

Systemic reaction (other): Felt bad this morning, feeling much better this afternoon. However, it appears I am developing the covid arm as I did with first shot. I believe it is just my sensitive skin and genetic makeup and allergies

2021-03-09

Systemic reaction (other): Was extremely tired last night. Went to bed at 8 slept 10 hours. Felt fine when I woke up. Just seem to need a little more rest past few days

Release 5 — day 14, dose 2

2021-03-17

Symptoms: Occasionally I have the dull headache like I did right after both vaccines. Still have some soreness in my left arm where I got 1st dose and developed the covid arm. Right arm where I had 2nd dose feels fine.

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Sore breasts for one week

Release 8 — 3 months, dose 2

2021-06-02

Symptoms: Left arm swelled w 1st shot, after 2nd shot. Breasts were full. Had some breasr underarm soreness for about 2 weeks. Was also taking provera for menapause issues. Soreness has gone away now.

Release 11 — 6 months, dose 3

2022-03-14

Symptoms: Had Covid 2/7 very mild stayed home 5 days. March 3rd developed Bronchitis. Took Steroids and inhaler and was fine. Friday March 12 was tired and woke up sat with congestion. Saw Dr today. Neg. flu &Covid.bad congestion but lungs clear. Guafison w co cut off by CDC

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	Breast pain	✓	✓	✓
SD	Bronchitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza virus test negative	·	·	✓
SD	Limb discomfort	✓	✓	✓
SD	Menopausal symptoms	✓	✓	✓
SD	Office visit	·	·	✓
SD	Patient isolation	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Induration	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Swelling	✓	✓	✓

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