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ZLZ-85097-11226

4 vaccinations 9 coded responses 55 check-ins 7 free-text entries 3 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
089 / NJ
Registered
2021-01-21
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-21
    Registered in v-safe
  2. 2021-01-21
    Dose 1 — Moderna
  3. 2021-01-21
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymphadenopathy, Nasal congestion, Oropharyngeal pain — Feeling: Fair
    Free text: Soreness left armpit, stuffy nose, sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-28
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-04
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-11
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-18
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-21
    Dose 2 — Moderna
  14. 2021-02-21
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  15. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  16. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  17. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  18. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  19. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache
    Adult check-in
  20. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches
    Adult check-in
  21. 2021-02-28
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-03-07
    Survey response — day 14, dose 2
    MedDRA: Hypoaesthesia, Musculoskeletal pain, Pain, Pain in extremity, Paraesthesia — Feeling: Fair
    Free text: Soreness in left upper arm and dull ache shoulder blade/back left side when moving left arm. Feels like a strain or something at rest. Numbness/tingling fingers left hand at times.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-03-14
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-21
    Survey response — day 28, dose 2
    MedDRA: Limb discomfort, Pain, Pain in extremity — Feeling: Good
    Free text: Pain/discomfort, upper left arm returned. Occurs with certain movement or positioning. Not constant. 3/10 pain scale.Concerned/Unsure why this continues
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-03-28
    Survey response — day 35, dose 2
    MedDRA: Muscle discomfort, Pain in extremity — Feeling: Fair
    Free text: Not new...continued muscle discomfort, left upper arm (tricep) and around left back (center, bottom of shoulder blade). Tricep pain sharp at times, depending on positioning.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-04-04
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-05-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-08-22
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-11-15
    Dose 3 — Moderna
  30. 2021-11-15
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  31. 2021-11-16
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Chills, Fatigue or tiredness
    Adult check-in
  32. 2021-11-17
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  33. 2021-11-18
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  34. 2021-11-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  35. 2021-11-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-22
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  38. 2021-11-29
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-12-06
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-12-15
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-12-20
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-12-27
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-02-14
    Survey response — 3 months, dose 3
    MedDRA: Mass, Pain in extremity, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Painful lump on top of my right foot. Not caused by an injury or accident. · Healthcare visit (other): I have an appointment scheduled.
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-02-14
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  45. 2022-02-16
  46. 2022-03-16
  47. 2022-03-16
    Call successful
    Does not wish to fill out VAERS report
  48. 2022-05-16
    Survey response — 6 months, dose 3
    MedDRA: Herpes zoster, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Shingles · Healthcare visit (other): Physicians offices
    MedDRA releases: 2024-11 · check-in free text available
  49. 2022-05-16
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  50. 2022-05-17
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  51. 2022-10-12
    Dose 4 — Moderna
  52. 2022-10-12
    Health check-in — day 0, dose 4
    Feeling: Good · None
    Adult check-in
  53. 2022-10-13
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  54. 2022-10-14
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  55. 2022-10-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  56. 2022-10-16
    Survey response — days 1–6 daily, dose 4
    MedDRA: Lymph node pain — Feeling: Good · Site: Pain
    Free text: lymph node still sore - underarm injection side
    MedDRA releases: 2024-11 · check-in free text available
  57. 2022-10-17
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  58. 2022-10-18
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  59. 2022-10-19
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  60. 2022-10-26
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  61. 2022-11-02
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  62. 2022-11-09
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  63. 2022-11-16
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  64. 2022-11-23
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  65. 2023-01-11
    Survey response — 3 months, dose 4
    MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    MedDRA releases: 2024-11
  66. 2023-04-12
    Survey response — 6 months, dose 4
    MedDRA: Antinuclear antibody positive, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  67. 2023-04-12
    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)
  68. 2023-04-13
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-01-21Moderna
22021-02-21Moderna
32021-11-15Moderna No
42022-10-12Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-02-14 Successful
2022-03-16
 Does not wish to fill out VAERS report
2022-05-16 Successful
2022-05-17
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-12 Successful
2023-04-13
 Participant prefers to complete VAERS report online

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Soreness left armpit, stuffy nose, sore throat

Release 5 — day 14, dose 2

2021-03-07

Symptoms: Soreness in left upper arm and dull ache shoulder blade/back left side when moving left arm. Feels like a strain or something at rest. Numbness/tingling fingers left hand at times.

Release 6 — day 28, dose 2

2021-03-21

Symptoms: Pain/discomfort, upper left arm returned. Occurs with certain movement or positioning. Not constant. 3/10 pain scale.Concerned/Unsure why this continues

Release 6 — day 35, dose 2

2021-03-28

Symptoms: Not new...continued muscle discomfort, left upper arm (tricep) and around left back (center, bottom of shoulder blade). Tricep pain sharp at times, depending on positioning.

Release 11 — 3 months, dose 3

2022-02-14

Symptoms: Painful lump on top of my right foot. Not caused by an injury or accident.
Healthcare visit (other): I have an appointment scheduled.

Release 11 — 6 months, dose 3

2022-05-16

Symptoms: Shingles
Healthcare visit (other): Physicians offices

Release 12 — days 1–6 daily, dose 4

2022-10-16

Systemic reaction (other): lymph node still sore - underarm injection side

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
HCVOUnevaluable event · · ✓
SDAntinuclear antibody positive · · ✓
SDCOVID-19 · · ✓
SDHerpes zoster · · ✓
SDHypoaesthesia ✓ ✓ ✓
SDLimb discomfort ✓ ✓ ✓
SDMass · · ✓
SDMuscle discomfort ✓ ✓ ✓
SDMusculoskeletal pain ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SDRash · · ✓
SROLymph node pain · · ✓
SROLymphadenopathy ✓ ✓ ✓
SRONasal congestion ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓

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

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