ZHW-10102-62882

2 vaccinations 9 coded responses 25 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 921 / CA
Registered: 2021-03-20

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Redness, Swelling · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension, Oropharyngeal pain, Palpitations, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: sore throat, increased heart palpitations especially last night; a couple of brief episodes of feeling high blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Idiopathic urticaria, Pre-existing disease, Urticaria — Feeling: Good · Site: Swelling

Free text: i have chronic idiopathic urticaria, and have noticed more hives today than i would normally have.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Erythema, Lymphadenopathy, Pre-existing disease — Feeling: Good · Fatigue or tiredness

Free text: I have chronic hives, and have still been experiencing more than the usual number per day, and also have tiny red dots that look like little bites scattered on my arms. Had swollen glands behind my ear on the injection side yesterday and the day before but forgot to add that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Survey response — day 14, dose 1
MedDRA: Injection site pruritus — Feeling: Good

Free text: The day after my last check-in, i developed itching at the injection site. There was no redness, rash, or swelling, and it went away after a few days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 21, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat has come and gone; mostly gone now. Ive always been prone to minor throat infections.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Cough, Headache, Oropharyngeal pain — Feeling: Good

Free text: I had a sore throat, cough, headache.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Herpes simplex, Pre-existing disease — Feeling: Good · Be unable to work or attend school, 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: Recurrence of ocular herpes simplex infection in the absence of known food/environmental triggers.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-20
Call 1 — Left Voicemail
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Herpes ophthalmic, Herpes virus infection, Herpes zoster, Injection site muscle weakness, Injection site pain — Feeling: Good · 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: Repeated herpes infections of facial skin and left eye since initial vaccination in 2021. Wound up back on prophylactic acyclovir. Right arm pain/weakness in arm where all 3 injections have been administered.

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 months, dose 2
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 · 1 call case(s)
2022-04-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-10-16	Unsuccessful
2022-04-17	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Sore throat

2021-03-22

Systemic reaction (other): sore throat, increased heart palpitations especially last night; a couple of brief episodes of feeling high blood pressure

2021-03-23

Systemic reaction (other): i have chronic idiopathic urticaria, and have noticed more hives today than i would normally have.

2021-03-24

Systemic reaction (other): I have chronic hives, and have still been experiencing more than the usual number per day, and also have tiny red dots that look like little bites scattered on my arms. Had swollen glands behind my ear on the injection side yesterday and the day before but forgot to add that.

Release 6 — day 14, dose 1

2021-04-03

Symptoms: The day after my last check-in, i developed itching at the injection site. There was no redness, rash, or swelling, and it went away after a few days.

Release 7 — day 21, dose 1

2021-04-10

Symptoms: Sore throat has come and gone; mostly gone now. Ive always been prone to minor throat infections.

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: I had a sore throat, cough, headache.

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Recurrence of ocular herpes simplex infection in the absence of known food/environmental triggers.

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: Repeated herpes infections of facial skin and left eye since initial vaccination in 2021. Wound up back on prophylactic acyclovir. Right arm pain/weakness in arm where all 3 injections have been administered.

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	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Herpes ophthalmic	·	·	✓
SD	Herpes simplex	·	·	✓
SD	Herpes virus infection	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Injection site muscle weakness	·	·	✓
SD	Injection site pain	·	·	✓
SD	Injection site pruritus	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Idiopathic urticaria	○	✓	○
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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