Z9N-31032-73598

4 vaccinations 10 coded responses 51 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 024 / MA
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — day 0, dose 1
MedDRA: Pain in jaw — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Pain in jaw on right side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

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

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Free text: Since I got vaccine I have had 3-4 episodes of feeling like blood sugar was low. That is feeling shaky and like I need to eat something NOW or I might pass out.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Hunger — Feeling: Good

Free text: I continue to feel very hungry often.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 1
MedDRA: Erythema, Feeling hot, Injection site swelling, Pruritus — Feeling: Good

Free text: For about four days my arm had a red, hot, and near the end, itchy spot. It was very swollen too it was right under where the needle had entered.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Sinus pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Last night couldnt stop shivering, sinus pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Last two nights I had night sweats and had to change clothes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 35, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Just slight soreness in arm that was vaccinated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-22
Dose 3 — Moderna
2021-08-23
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-08-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-08-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-08-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-08-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-08-29
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-09-05
Survey response — day 14, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · 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: Sore throat

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-08
Call 1 — Left Voicemail
2021-09-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-09-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-01-25
Dose 4 — Moderna
2022-01-26
Survey response — days 1–6 daily, dose 4
MedDRA: Sinus pain — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sinus pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-01-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-01-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-01-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-01-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-01
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-02-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-02-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-02-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-03-08
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-04-26
Survey response — 3 months, dose 4
MedDRA: Periorbital swelling — Feeling: Fair

Free text: Swelling around eyes after yardwork. Reaction to bug bite or allergies?

MedDRA releases: 2024-11 · check-in free text available
2022-07-26
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-01-25
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-08-22	Moderna	No
4	2022-01-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-05	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-05

Systemic reaction (other): Pain in jaw on right side

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Since I got vaccine I have had 3-4 episodes of feeling like blood sugar was low. That is feeling shaky and like I need to eat something NOW or I might pass out.

2021-03-11

Systemic reaction (other): I continue to feel very hungry often.

Release 6 — day 21, dose 1

2021-03-26

Symptoms: For about four days my arm had a red, hot, and near the end, itchy spot. It was very swollen too it was right under where the needle had entered.

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Last night couldnt stop shivering, sinus pain

2021-04-05

Systemic reaction (other): Last two nights I had night sweats and had to change clothes

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Just slight soreness in arm that was vaccinated.

Release 9 — day 14, dose 3

2021-09-05

Symptoms: Sore throat

Release 11 — days 1–6 daily, dose 4

2022-01-26

Systemic reaction (other): Sinus pain

Release 11 — 3 months, dose 4

2022-04-26

Symptoms: Swelling around eyes after yardwork. Reaction to bug bite or allergies?

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	Erythema	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Periorbital swelling	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hunger	✓	✓	✓
SRO	Nervousness	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Sinus pain	✓	✓	✓

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