ZH7-27588-67078

4 vaccinations 8 coded responses 37 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 431 / OH
Registered: 2021-01-19

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-15
Dose 1 — Moderna
2021-01-19
Registered in v-safe
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass — Feeling: Good · Site: Pain, Swelling

Free text: Lump under my left arm. Received shot in same arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Axillary mass, Axillary pain — Feeling: Good

Free text: Lump under arm and soreness remains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Dizziness, Headache, Pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: I had headache, chills, body aches, dizziness... woke up today feeling fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 35, dose 2
MedDRA: Axillary mass, Discomfort, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lump under arm... Uncomfortable... discomfort is not constant · Healthcare visit (other): Made an appointment with my gynecologist for Monday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-22
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-19
Dose 3 — Moderna
2022-01-14
Call 1 — Left Voicemail
2022-02-21
Survey response — 12 months, dose 2
MedDRA: Abdominal discomfort, Diarrhoea, Ear disorder, Headache, Illness, Nausea, SARS-CoV-2 test negative, Sinus disorder — Feeling: Good · Be unable to work or attend school

Free text: Sinus and ear issues, upset stomach diarrhea and nausea. Headache may have been due to severe dehydration. In total the sickness lasted about six days. I tested negative for Covid twice during that time.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Dose 4 — Moderna
2022-05-04
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling · None

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-11
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-01
Survey response — day 28, dose 4
MedDRA: Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-02
Call 2 — Left Voicemail
2022-06-02
Call 1 — Left Voicemail
2022-06-08
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-03
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-02
Survey response — 6 months, dose 4
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rash on left side of back

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-03
Call 3 — Left Voicemail
2022-11-03
Call 2 — Left Voicemail
2022-11-03
Call 1 — Left Voicemail
2023-05-06
Survey response — 12 months, dose 4
MedDRA: Office visit, Tooth abscess — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-06
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-19	Moderna
3	2021-11-19	Moderna	No
4	2022-05-04	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-26	Successful 2023-05-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-01	Successful 2023-05-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-02	Successful 2023-05-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-06	Successful 2023-05-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Lump under my left arm. Received shot in same arm.

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Lump under arm and soreness remains

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): I had headache, chills, body aches, dizziness... woke up today feeling fine.

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Lump under arm... Uncomfortable... discomfort is not constant

Healthcare visit (other): Made an appointment with my gynecologist for Monday

Release 11 — 12 months, dose 2

2022-02-21

Symptoms: Sinus and ear issues, upset stomach diarrhea and nausea. Headache may have been due to severe dehydration. In total the sickness lasted about six days. I tested negative for Covid twice during that time.

Release 11 — day 28, dose 4

2022-06-01

Symptoms: Sinus infection

Release 12 — 6 months, dose 4

2022-11-02

Symptoms: Rash on left side of back

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	·	·	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Abdominal discomfort	·	·	✓
SD	Axillary mass	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Discomfort	✓	✓	✓
SD	Ear disorder	·	·	✓
SD	Headache	·	·	✓
SD	Illness	·	·	✓
SD	Nausea	·	·	✓
SD	Rash	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Sinusitis	·	·	✓
SD	Tooth abscess	·	·	✓
SRO	Axillary mass	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain	✓	✓	✓

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