ZJR-19933-94338

5 vaccinations 9 coded responses 41 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 600 / IL
Registered: 2021-01-31

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-01-31
Registered in v-safe
2021-01-31
Dose 1 — Moderna
2021-01-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: I have a ganglion cyst in one of my hand joints which has become extremely enlarged after the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Synovial cyst — Feeling: Good

Free text: Ganglion cyst in finger joint is still inflamed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Synovial cyst — Feeling: Good

Free text: Ganglion cyst in finger joint still inflamed but less than 2 days ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Inflammation, Synovial cyst — Feeling: Good

Free text: Ganglion cyst in knuckle still inflamed same as yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — day 7, dose 1
MedDRA: Inflammation, Synovial cyst — Feeling: Good

Free text: Ganglion cyst in knuckle still inflamed no change since yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — day 14, dose 1
MedDRA: Office visit, Toothache — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Tooth ache, probably need root canal · Healthcare visit (other): Periodontist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-21
Survey response — day 21, dose 1
MedDRA: Office visit, Root canal infection — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Root canal · Healthcare visit (other): Endodontist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-28
Dose 2 — Moderna
2021-02-28
Health check-in — day 0, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

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

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

Adult check-in
2021-04-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Call 2 — Could Not Reach Participant
2021-08-09
Call 2 — Could Not Reach Participant
2021-08-09
Call 3 — Could Not Reach Participant
2021-08-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Dose 3 — Moderna
2021-10-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-01
Dose 4 — Moderna
2022-05-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-31
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-24
Dose 5 — Moderna
2022-10-19
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-29
Survey response — day 35, dose 5
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — day 35, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 3 — Left Voicemail
2022-10-31
Call X — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-11-05
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-24
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-25
Survey response — 6 months, dose 5
MedDRA: COVID-19 — 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 · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-25
Report sent to call center — 6 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-28
Call 1 — Left Voicemail
2023-03-28
Call 1 — Left Voicemail
2023-03-28
Call 1 — Left Voicemail
2023-03-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-31	Moderna
2	2021-02-28	Moderna
3	2021-09-16	Moderna	No
4	2022-05-01	Moderna	No
5	2022-09-24	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-14	Unsuccessful
2021-02-21	Unsuccessful
2022-10-29	Unsuccessful
2023-03-25	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I have a ganglion cyst in one of my hand joints which has become extremely enlarged after the injection

2021-02-03

Systemic reaction (other): Ganglion cyst in finger joint is still inflamed

2021-02-05

Systemic reaction (other): Ganglion cyst in finger joint still inflamed but less than 2 days ago

2021-02-06

Systemic reaction (other): Ganglion cyst in knuckle still inflamed same as yesterday

Release 3 — day 7, dose 1

2021-02-07

Systemic reaction (other): Ganglion cyst in knuckle still inflamed no change since yesterday

Release 4 — day 14, dose 1

2021-02-14

Symptoms: Tooth ache, probably need root canal

Healthcare visit (other): Periodontist

Release 4 — day 21, dose 1

2021-02-21

Symptoms: Root canal

Healthcare visit (other): Endodontist

Release 12 — day 35, dose 5

2022-10-29

Symptoms: Sore throat, congestion

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	COVID-19	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Root canal infection	✓	✓	✓
SD	Toothache	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Synovial cyst	✓	✓	✓

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