ZJD-27150-25379

2 vaccinations 9 coded responses 18 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 330 / FL
Registered: 2021-04-06

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity, Peripheral swelling, Tenderness — Feeling: Good

Free text: Last night I had pain I could not touch my arm and it swelled a little; this morning it is better

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

Free text: It is almost not swollen anymore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 1
MedDRA: Contusion, Peripheral swelling, Pre-existing disease — Feeling: Good

Free text: My mom has Alzheimers and cant speak for herself. She has no symptoms since she got the first dose but her right arm is a little swollen and bruised. Yesterday I spoke with (b)(6) from (b)(6) about my mom.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Dose 2 — Moderna
2021-05-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Dementia Alzheimer's type, Erythema, Fatigue, Headache, Peripheral swelling, Pre-existing disease, Self-medication, Tremor — Feeling: Poor · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My mon has Alzheimer, she received the 2nd dose of Moderna before yesterday but her symptoms are worse today. Her arm is more swollen today and red. My Mom feels very tired and keeps touching her forhead. She keeps her eyes closed. I also notice that sometimes her body shakes. She took Tylenol and I put ice on her arm; no fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Peripheral swelling, Salivary hypersecretion — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Her arm is still red and swollen, down to her elbow. This morning she was spitting up a lot of saliva. Yesterday when I put ice in on her arm she had a reaction. I did the same today and she didnt say anything. She doent have a fever.PLEASE I need to know what I can do to help my mom.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Redness, Swelling

Free text: Mom's thick saliva collects in her mouth. she has a mild, dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 7, dose 2
MedDRA: Choking, Cough, Throat irritation — Feeling: Fair · Headache

Free text: She has on itchy throat an cough. She is chokes while eating and when she is not

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 21, dose 2
MedDRA: Eye discharge, Salivary hypersecretion — Feeling: Fair · Be unable to do your normal daily activities

Free text: She wakes up with eye boogers in her left eye. It looks like white stuff in the corner of her eye. She continues to spit up salvia but shes eating ok.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — day 35, dose 2
MedDRA: Salivary hypersecretion — Feeling: Fair

Free text: AÃºn sigue juntÃ¡ndose la saliva en su boca es bastante incÃ³modo, se presenta en cualquier momento del dÃa.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-04	Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-08

Systemic reaction (other): Last night I had pain I could not touch my arm and it swelled a little; this morning it is better

2021-04-09

Systemic reaction (other): It is almost not swollen anymore

Release 8 — day 21, dose 1

2021-04-27

Symptoms: My mom has Alzheimers and cant speak for herself. She has no symptoms since she got the first dose but her right arm is a little swollen and bruised. Yesterday I spoke with (b)(6) from (b)(6) about my mom.

redacted (b)(6)

Release 8 — days 1–6 daily, dose 2

2021-05-06

Systemic reaction (other): My mon has Alzheimer, she received the 2nd dose of Moderna before yesterday but her symptoms are worse today. Her arm is more swollen today and red. My Mom feels very tired and keeps touching her forhead. She keeps her eyes closed. I also notice that sometimes her body shakes. She took Tylenol and I put ice on her arm; no fever

2021-05-07

Systemic reaction (other): Her arm is still red and swollen, down to her elbow. This morning she was spitting up a lot of saliva. Yesterday when I put ice in on her arm she had a reaction. I did the same today and she didnt say anything. She doent have a fever.PLEASE I need to know what I can do to help my mom.

2021-05-10

Systemic reaction (other): Mom's thick saliva collects in her mouth. she has a mild, dry cough

Release 8 — day 7, dose 2

2021-05-11

Systemic reaction (other): She has on itchy throat an cough. She is chokes while eating and when she is not

Release 8 — day 21, dose 2

2021-05-27

Symptoms: She wakes up with eye boogers in her left eye. It looks like white stuff in the corner of her eye. She continues to spit up salvia but shes eating ok.

Release 9 — day 35, dose 2

2021-06-10

Symptoms: AÃºn sigue juntÃ¡ndose la saliva en su boca es bastante incÃ³modo, se presenta en cualquier momento del dÃa.

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	Contusion	✓	✓	✓
SD	Eye discharge	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Salivary hypersecretion	✓	✓	✓
SRO	Choking	✓	✓	✓
SRO	Condition aggravated	○	✓	○
SRO	Cough	✓	✓	✓
SRO	Dementia Alzheimer's type	○	✓	○
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	○	✓	○
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Salivary hypersecretion	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Tenderness	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Tremor	✓	✓	✓

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