ZDD-12136-27839

4 vaccinations 11 coded responses 48 check-ins 10 free-text entries 8 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 140 / NY
Registered: 2021-01-08

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

2021-01-07
Dose 1 — Moderna
2021-01-08
Registered in v-safe
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Fair · Nausea, Abdominal pain

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-06
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 do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 28, dose 2
MedDRA: Cellulitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cellulitus in lower left calf

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat and headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Call 1 — Left Voicemail
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Headache — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headaches

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-16
Call 1 — Left Voicemail
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Fever · Chills

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in arm pit on same side where i received the injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Medical counselling, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Swelling under arm pit under injection site, painful, contacted primary doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Enlarged lymph node under arm on same side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-11-03
Call successful
Participant prefers to complete VAERS report online
2021-11-03
Call successful
Participant prefers to complete VAERS report online
2021-11-03
Call successful
Participant prefers to complete VAERS report online
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 28, dose 3
MedDRA: Aphonia, Headache, Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · 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: Chest congestion, sore throat, headache. Loss of voice

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-03
Call 1 — Left Voicemail
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Injected limb mobility decreased, Injection site pain — Feeling: Good · 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: Left arm where shot was still hurts and i can only keep my arm up for a few minutes at a time

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call successful
Participant prefers to complete VAERS report online
2022-02-01
Call successful
Participant prefers to complete VAERS report online
2022-04-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-30
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-14
Survey response — day 14, dose 4
MedDRA: Nephrolithiasis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Kidney stone

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-17
Call 1 — Left Voicemail
2022-10-21
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-28
Survey response — day 28, dose 4
MedDRA: Renal stone removal, Surgery — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Kidney stone removal · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail
2022-11-04
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-31
Survey response — 6 months, dose 4
MedDRA: Sinusitis — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-10-29	Moderna	No
4	2022-09-30	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	priority 2/3
2021-03-04	Successful 2021-11-03	Participant prefers to complete VAERS report online
2021-08-07	Successful 2021-11-03	Participant prefers to complete VAERS report online
2021-11-01	Successful 2021-11-03	Participant prefers to complete VAERS report online
2021-11-26	Successful 2022-02-01	Participant prefers to complete VAERS report online
2022-01-28	Successful 2022-02-01	Participant prefers to complete VAERS report online
2022-10-14	Unsuccessful
2022-10-28	Unsuccessful

Free text

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Cellulitus in lower left calf

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Sore throat and headache

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Headaches

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Pain in arm pit on same side where i received the injection

2021-11-01

Systemic reaction (other): Swelling under arm pit under injection site, painful, contacted primary doctor

2021-11-02

Systemic reaction (other): Enlarged lymph node under arm on same side of injection

Release 10 — day 28, dose 3

2021-11-26

Symptoms: Chest congestion, sore throat, headache. Loss of voice

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Left arm where shot was still hurts and i can only keep my arm up for a few minutes at a time

Release 12 — day 14, dose 4

2022-10-14

Symptoms: Kidney stone

Release 12 — day 28, dose 4

2022-10-28

Symptoms: Kidney stone removal

Healthcare visit (other): Outpatient surgery

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	Surgery	·	·	✓
SD	Aphonia	·	·	✓
SD	Cellulitis	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injected limb mobility decreased	·	·	✓
SD	Injection site pain	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Renal stone removal	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Medical counselling	·	·	✓
SRO	Oedema peripheral	·	·	✓

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