ZEB-15952-03411

2 vaccinations 13 coded responses 28 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 674 / KS
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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: I have had a couple spells of being lite headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Injection site is sore and bruised

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising, Injection site pain — Feeling: Good · Site: Pain

Free text: Pain and bruising is bigger at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 28, dose 1
MedDRA: Herpes zoster, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I have the shingles · Healthcare visit (other): Dr office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 35, dose 1
MedDRA: Herpes zoster, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I found out I had shingles and was told to wait to get 2nd shot · Healthcare visit (other): Dr office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 35, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Survey response — day 42, dose 1
MedDRA: Asthenia, Pyrexia, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Last night I had a bout of vomiting and fever. Has lasted bout 12 hours. Still feel weak but vomiting has stoppedNot related to vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Dose 2 — Moderna
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site swelling, Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness

Free text: Redness and swelling and heat of 101.8 in injection sight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Pain, Vaccination site swelling, Vaccination site warmth — Feeling: Good · Site: Pain, Redness, Swelling

Free text: Just the swelling and redness and heat coming from my shoulder where I got the vaccine. Temp of the redness is 101.5 today while my temp is normal. Really swollen and sore are and movement hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pain in extremity, Skin warm — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: ATM is still sore really red and has heat and fever in it of 101.8. My temp it normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Pain — Feeling: Good · Site: Pain, Redness, Swelling

Free text: Still have a red spot that has a lot of heat in it. Not as sore as yesterday but still sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain

Free text: Just pain in the injection arm. Swelling and redness seem to be a lot better today. Just pain in upper arm when using it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Just soreness on the arm I got the vaccine in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Survey response — day 42, dose 2
MedDRA: Erythema, Feeling hot, Oedema peripheral, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Arm is really sore 3-4 inches below injection site. It is in the mussel and hurts badly when I lift things. Couple days ago it was just throbbing. All is in the area where I had the red lump swelling and heat in reb lump.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Call 1 — Left Voicemail
2022-04-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-04-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-12	Unsuccessful
2021-03-19	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-12

Systemic reaction (other): I have had a couple spells of being lite headed

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Injection site is sore and bruised

2021-02-14

Systemic reaction (other): Pain and bruising is bigger at injection site

Release 5 — day 28, dose 1

2021-03-12

Symptoms: I have the shingles

Healthcare visit (other): Dr office visit

Release 5 — day 35, dose 1

2021-03-19

Symptoms: I found out I had shingles and was told to wait to get 2nd shot

Healthcare visit (other): Dr office visit

Release 6 — day 42, dose 1

2021-03-26

Symptoms: Last night I had a bout of vomiting and fever. Has lasted bout 12 hours. Still feel weak but vomiting has stoppedNot related to vaccine

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Redness and swelling and heat of 101.8 in injection sight

2021-04-09

Systemic reaction (other): Just the swelling and redness and heat coming from my shoulder where I got the vaccine. Temp of the redness is 101.5 today while my temp is normal. Really swollen and sore are and movement hurts

2021-04-10

Systemic reaction (other): ATM is still sore really red and has heat and fever in it of 101.8. My temp it normal

2021-04-11

Systemic reaction (other): Still have a red spot that has a lot of heat in it. Not as sore as yesterday but still sore.

2021-04-12

Systemic reaction (other): Just pain in the injection arm. Swelling and redness seem to be a lot better today. Just pain in upper arm when using it.

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Just soreness on the arm I got the vaccine in.

Release 8 — day 42, dose 2

2021-05-18

Symptoms: Arm is really sore 3-4 inches below injection site. It is in the mussel and hurts badly when I lift things. Couple days ago it was just throbbing. All is in the area where I had the red lump swelling and heat in reb lump.

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	Office visit	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Oedema peripheral	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Skin warm	✓	✓	✓
SRO	Vaccination site swelling	✓	✓	✓
SRO	Vaccination site warmth	✓	✓	✓

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